多层螺旋CT在闭合性甲状软骨损伤诊断中的价值

目的 探讨多层螺旋CT(multi-slice spiral computed tomography,MSCT)扫描在闭合性甲状软骨损伤诊断中的成像方法及应用价值.方法 对闭合性甲状软骨损伤5例患者进行MSCT扫描,重建数据在Advantage Workstation 4.0工作站进行二维、三维图像处理.其中联合应用多平面重组(multi-planar reconstruction,MPR)4例次,容积重建(3D-volume reconstruction,3D-VR)3例次,仿真喉镜成像(computed tomography virtual laryngoscope,CTVL)1例次.结果 5例患者中发现甲状软骨左板骨折4例,右板骨折1例;其中合并环状软骨骨折1例,合并上气道狭窄1例.利用窄窗宽低窗位技术有助于显示软骨结构,本组4例利用MPR图像进行多角度观察,对显示骨折线的走行及移位能取得满意的效果.3例利用3D-VR图像显示软骨结构的空间改变,其立体效果能为临床医牛选择治疗方案提供依据.1例运用CTVL技术对上气道狭窄及狭窄程度做出明确诊断.结论 MSCT扫描能够清晰地显示闭合性甲状软骨骨折及上气道狭窄,选择合适的后处理技术或多种技术联合运用能够提供准确、直观的图像.

Value of multi-slice spiral CT in the diagnosis of closed thyroid cartilage injury

OBJECTIVE: To explore the clinical application and to evaluate the value of multi-slice spiral computed tomography (MSCT) in closed thyroid cartilage injury. METHODS: MSCT scan was performed in 5 patients with closed thyroid cartilage injury, and 2D and 3D images reconstructions were achieved after volumn data was transferred to workstation. RESULTS: In 5 cases, the thyroid cartilage fracture was found in left board in 4 patients, in right board in 1 patient. In addition, one patient had concurrent cricoid cartilage fracture and another patient had laryngotracheal stenosis. These fractures and changes were all visualized by 2D and 3D images. Lower window level and window width were helpful to reveal the structures of thyroid cartilage. Multi-planar reconstruction (MPR) was superior in displaying alignment and displacement of fracture in 4 cases. 3D-volume reconstruction (3D-VR) was accurate in displaying space change of cartilage structures. In 3 cases, the evaluation of 3D-VR was accurate in assessing the length, width and shape of fracture, providing helpful data for the clinician to adopt the optimal management Computed tomography virtual laryngoscope (CTVL) helped to offer the criterions to the diagnosis of upper airway stricture and the location of laryngotracheal stenosis in one case. CONCLUSIONS: MSCT was useful in the diagnosis and management of closed thyroid cartilage injury and the laryngotracheal stenosis. It was believed that the reasonable use of the reprocessing technique plays an important role in the diagnosis, treatment and evaluation of the effect of closed thyroid cartilage injury.