外伤性视神经管骨折的高分辨率CT诊断

目的探讨高分辨率CT扫描及重建技术对视神经管骨折的诊断意义。方法回顾性分析视神经管骨折18例，采用高分辨率CT扫描并进行边缘算法或骨算法重建，对CT图像进行分析。结果本组18例21眼视神经管骨折。单壁骨折12眼，占57．14％，多壁骨折9眼，占42．86％。单壁骨折12眼中，单纯内壁骨折6眼，外壁骨折1眼，上壁骨折2眼。下壁骨折3眼。多壁骨折9眼中，内壁合并上壁骨折2眼，外壁合并上壁骨折1眼，内壁合并上壁、下壁骨折5眼，内壁合并上壁、下壁、外壁骨折1眼。总计4个壁共37壁次骨折，其中内壁骨折14眼，占37．84％，是4个壁中发生骨折最多者；外壁骨折3眼，占8．11％，是4个壁中发生骨折最少者；上壁骨折11眼，占29．73％；下壁骨折9眼，占24．32％。本组骨折有3种类型：线状型骨折，粉碎型骨折及混合型骨折。结论应用高分辨率CT扫描及适当的重建技术，能够清晰地显示视神经管的结构，对视神经管骨折进行有效地诊断，有助于临床上把握手术时机，及早制定合理的治疗方案。

HRCT diagnosis of optical canal fractures

Objective To evaluate the diagnostic significance of HRCT and reconstruction in detection of fracture of optic canal. Methods Eighteen cases of fractures of optic canal were detected by high resolusion CT(HRCT)and reconstructed with edge algorithm or bone algorithm.The CT features of images were analyzed. Results Twenty-one fractures of optic canal were observed in 18 cases,which included 12 cases fractures in one wall(57.14%),9 in multi-wall(42.86%);6 in single medial wall,1 in single lateral wall,2 in single superior wall,and 3 in single inferior wall;2 in medial and superior walls,1 in lateral and superior walls,5 in medial,superior and inferior walls,1 in medial,lateral, superior and inferior walls.Totally,there are 37 fractures of whole walls of optic canals,14 in medial wa11(37.84%),3 in lateral wall(8.11%),11 in superior wa11(29.73%),and 9 in inferior wa11(24.32%).The fractures of optic canal on CT images were divided into three types: lineal;comminuted and mixed fractures.Conclusion Applied with HRCT scanning and appropriate reconstruction,the fracture of optic canal can be efficaciously diagnosed in order to choose the sugery opportunity early or rational therapy.