螺旋CT扫描立体成像对眼眶爆裂骨折的诊断价值

目的 分析眼眶爆裂骨折螺旋CT（SCT）容积扫描的表现,旨在对本病作出早期诊断。资料与方法 回顾性分析80例眼眶爆裂骨折的SCT轴位扫描图像以及多平面重建（MPR）和三维（3D）重建立体图像的CT表现。并根据CT征象将其分为3型：（1）单眶壁爆裂骨折;（2）双眶壁爆裂骨折;（3）混合型骨折（并发其他面部直接骨折的爆裂骨折）。结果 眼眶爆裂骨折的直接SCT征象为眶壁骨质连续性中断、粉碎、凹陷及曲度失常;上颌窦和筛窦内“泪滴征”是诊断眼眶下壁和内侧壁爆裂骨折的特异性间接征象。由于骨折局部往往伴有软组织增厚及眼外肌的改变,所以对早期诊断、选择治疗方法、估计预后及法医学鉴定可提供更多的信息。结论 SCT容积扫描立体成像对诊断眼眶爆裂骨折具有重要价值。

The Evaluation of Spiral CT 3-D Reconstruction in the Diagnosis of Orbital Blowout Fracture

Objective To analyze spiral CT (SCT) volume scanning findings of orbital blowout fracture, to improve its early diagnosis.Materials and Methods SCT MPR, 3 D reconstruction and axial scan findings in 80 patients with orbital blowout fracture were retrospectively analyzed. Based on CT signs, the fractures were divided into 3 types: (1) blowout fracture of unilateral orbital wall; (2) blowout fracture of bilateral orbital walls; (3) mixed fracture, complicated with other direct facial fractures. Results The direct signs of orbital blowout fracture included continuity interruption, fragments, depression and displacement of orbital bony wall. "Tear drop" sign seen in the maxillary or ethmoid sinus was a characteristic indirect sign in inferior or medial orbital wall fracture. The other manifestation was thickened and enlarged extraocular orbital muscles.Conclusion SCT volume scanning and MPR, 3-D reconstruction is of great value in the diagnosis of orbital blowout fracture.