多层螺旋CT后处理技术对胫骨平台隐匿性骨折的诊断价值

目的探讨多层螺旋CT后处理技术对胫骨平台隐匿性骨折的诊断价值。方法对16例临床上可疑胫骨平台隐匿性骨折患者采用多层螺旋CT进行扫描,同时在工作站上作3D及MPR影像后处理,16例患者CT扫描前均采用X线片检查。并就X线平片与多层螺旋CT影像进行比较和综合分析。结果 16例胫骨平台隐匿性骨折中,X线平片漏诊10例,可疑诊断6例,螺旋CT均予以诊断。3D影像可清晰显示胫骨平台骨折的立体形态;MPR影像则可明确显示胫骨平台内部的骨质损伤情况如骨折的具体部位、关节面碎裂及塌陷程度、骨折移位距离。结论螺旋CT及后处理技术对胫骨平台隐匿性骨折的诊断具有很高的准确性,明显优于X线平片,当临床怀疑骨折而X线片未显示或显示不清时应及时行CT检查。

Diagnostic value of postprocess technique with multi-slice spiral CT foR16 cases of occult fractures in tibial plateau

Objective To explore the clinical value of postprocess technique with multi-slice spiral CT for occult fractures in tibial plateau.Methods Postprocessing techniques including MPR and 3D-MIP were performed on 16 cases suspected of occult fracture in tibial plateau,and X-ray scanning was also performed.Imaging display respectively from multi-slice spiral CT and X-ray was further compared and analyzed.Results All the 16 cases suspected of occult fracture in tibial plateau were accurately diagnosed by multi-slice spiral CT.On the contrast,10 cases of them were ignored and missed using X-ray scanning although the remained 6 cases were diagnosed with unsatisfactory imaging display of fractures.3-D of multi-slice spiral CT distinctly demonstrated stereoscopic shape of fractures in tibial plateau.MPR of multi-slice spiral CT accurately demonstrated internal morphological changes of bone lesion in tibial plateau such as location of fracture,disruption and collapse of articular surface,and distance of fracture dislocation.Conclusion The postprocessing techniques of multi-slice spiral CT are more accurate in the diagnosis of occult fracture in tibial plateau and therefore should be applied to clinically suspicious cases.