Lisfranc骨折脱位影像学表现

目的探讨X线平片、螺旋CT多平面重建(MPR)、表面遮盖显示法(SSD)及最大密度投影法(MIP)在Lisfranc关节骨折脱位诊断中的价值。材料与方法回顾性分析20例Lisfranc骨折脱位患者的X线平片、螺旋CT的MPR、SSD及MIP图像;所有病例均拍摄X线平片,其中有9例行螺旋CT扫描并用MPR、SSD及MIP技术获得多平面重组和三维重建图像。结果 X线平片及螺旋CT检查综合诊断20例Lisfranc骨折脱位,其中A型5例(25%),B型11例(55%),C型4例(20%);20例均有跖骨骨折,其中多发骨折16例(80%),单发骨折4例(20%);粉碎性骨折11例(55%)、横行骨折6例(30%)、斜行骨折3例(15%);伴有楔骨骨折5例(25%)、舟骨骨折3例(15%)、骰骨骨折2例(10%)。20例Lisfranc骨折脱位均影像清晰,诊断明确。结论 X线平片、螺旋CT多平面重组及三维重建在诊断Lisfranc骨折脱位中有重要的价值。

Imaging Findings of Lisfranc Fracture-dis- location

Objective To evaluate the clinical application value of X-ray film,multiplanar reconstruction（MPR）,shaded surface display （SSD） and maximunl intensity projection￡MIP￡with spiral CT to lisfranc fracture-dislocations. Methods The authors analyzed retrospectively the images of Radiograph, MPR, SSD and MIP in 20 patients of lisfranc fractures-dislocations. These cases were examined by X-ray,and 9 cases were scaned by spiral CT, then the multiplanar and three-dimensional images were obtained by techniques of MPR, SSD and MIP on a workstation. Results On the images of radiograph. MPR, SSD and MIP, 20 cases lisfianc fi＇acture-dislocations were found, inclding type A（5 cases,25%）, type B（11 cases,55%）, type C（4 cases, 20%）. 20 cases had metatarsal fractures： multiple fiacture 16 cases（80%）,single fracture 4 cases（20%）： comminuted fracture II cases（55%）, transverse fracture 6 cases（30%）, oblique fracture 4 cases（20%）; and with cuneifornt fracture 5 cases（20%）, navicular fracture 3 cases（ 15% ）, cuboid fiacturc 2 cases （ 10%）.20 cases lisfranc fracture-dislocations were displayed clearly and diagnosis definitely. Conclusion Radiograph,multiplanar reconstruction, shaded surface display and maximum intensity projection with spiral CT are the important methods to diagnose lisfranc fracture- dislocations.