多层螺旋CT在骨关节创伤中的诊断价值

目的:探讨16层螺旋CT(16-MSCT)在骨关节创伤中的应用价值。方法:37例创伤性骨折病例经常规X线平片检查后,应用16层螺旋CT机扫描,在工作站进行表面遮盖(SSD)、容积再现(VR)及多平面重组(MPR),并与CT轴位图像(axial)、X线平片(X-rayplainfilm)比较。结果:37例创伤性骨折,依据轴位扫描及MPR、SSD、VR重建图像资料共发现骨折59处,CT轴位图像共发现骨折59处;MPR发现59处;三维表面遮盖法重建(SSD)发现48处,检出率81.3%,容积重建技术(VR)发现49处,检出率83.0%;X线平片发现骨折44处,检出率74.6%。经统计学分析,上述几种方法检出爆裂性骨折的创伤量无显著性差异。16层SCT的重组影像可清晰显示骨折的立体形态;MPR影像则可明确显示骨折内部的骨质损伤情况如骨折的具体部位、表面碎裂及塌陷程度、骨折移位距离。结论:16-MSCT能够显示X线平片难于诊断的隐匿性骨折;三维重组及MPR成像技术有利于全面观察骨折的形态变化。

Clinical application of 16 slice spiral CT to bone and joint trauma

Objective To evaluate the diagnostic value of 16 slice spiral CT in assessment of traumatic fracture. Method After conventional X-ray plain film of 37 cases of traumatic fracture were performed, these patients were examed with scanning of 16 slice SCT.SSD,VR and MPR was acquired with reforming axial imaging of 16 slice SCT on workstation,and then compared with the findings of axial and X-ray plain film. Results For 37 cases of traumatic fracture , the total fracture quantity was 59 ( axial was 59, MPR was 59, SSD was 48 , VR was 49, X-ray plain film was 44. Fracture detection rates of SSD,VR and X-ray were 81.3%,83% and 74.6%.The difference with X-ray plain film, axial, VRT and MPR was not statistically significant of traumatic fractures. The restructured image of 16-MSCT could distinctly demonstrate stereoscopic shape of fractures. MPR of 16 slice SCT could accurately demonstrate internal morphological changes of bone lesion such as location of fracture,disruption and collapse of articular surface, distance of fracture dislocation. Conclusion 16 slice SCT can effectively reveal the occult fractures ,those were not visible on X-ray plain film.3-D and MPR are very beneficial to entirely observing the morphological changes of traumatic fractures.