螺旋CT三维和多平面重建在胸腰椎骨折中的临床应用

目的：探讨螺旋CT三维和多平面重建在胸腰椎骨折中临床应用价值。材料和方法：回顾性分析23例胸腰椎骨折和螺旋CT扫描及三维和多平面重建资料。重点观察椎体骨折的部位、椎体序列、椎体高度、骨折线、椎体附件和旋转／脱位等的CT表现。结果：23例中轴位CT显示27个椎体骨折，25个横突骨折，3个棘突骨折，3个椎弓根骨折，15个椎板骨折，4个椎间关节脱位，0个椎体脱位，1个椎体旋转，25个椎管狭窄。三维重建显示分别为27、15、3、2、7、2、4、1、25个；多平面重建显示上述结构骨折分别为27、5、3、2、5、2、4、0、25个。三维和多平面重建显示椎体骨折效果好，但对附件的显示相对较差。在显示椎体的脱位和／或旋转方面三维重建最为直观。结论：胸腰椎骨折的螺旋CT三维和多平面重建，是辅位CT扫描有价值的补充手段。进行三维和多平面重建规范化操作流程，可提高其诊断效果。

Clinical Application of 3-Dimensional and Multiplanar Reconstruction with Spiral CT in the Thoracolumbar Spine Fractures

Objective:To evaluate the clinical value of 3D and multiplanar reconstruction of helical CT in thoracolumbar spine fractures.Materials and Methods:Twenty-three patients underwent helical CT scanning.All of the thoracic/lumbar spine fractures were reformed by the way of 3D and multiplanar reconstruction(MPR).Each study was evaluated for the CT manifestation of the level of the fracture,vertebral alignment,vertebral height loss,line of fracture,posterior element involvement,narrowing of the spinal canal,and the grade of rotation and/or dislocation.Results:In 23 patients Axial CT demonstrated 27 vertebral body fractures,25 transverse process fractures,3 spinous process fractures,3 pedicles fractures,15 laminal fractures,4 articular dislocations,0 vertebral dislocation,1 rotation and 25 narrowing of spinal canal;accordingly 3D surfoce reconstruction demonstrated as folloling,respectively:27?15?3?2?7?2?4?1 and MPR were 25 and 27?5?3?2?5?2?4?0 and 25,respectively.3D and MPR could demonstrate vertebral body fracture well,bat for dislocation and/or rotation3D surface reconstruction was better.Conlusion:3D and MPR of spiral CT were useful method in the diagnosis of thoracic and lumbar spine fractures,and they could provide additional information if employing a standard protocol of reconstruction.