多层螺旋CT多平面和三维重建在胫骨平台骨折中的临床应用

目的 探讨多层螺旋CT(MSCT)多平面重建(MPR)和三维重建(3D)在胫骨平台骨折中的临床应用价值.方法 回顾性分析我院2002年6月至2005年9月诊治的84例胫骨平台骨折患者的影像学资料.84例患者轴位CT扫描后行MPR和3D成像,并与X线平片对照分析.结果 84例胫骨平台骨折中,胫骨外侧平台骨折36例,内侧平台骨折2例,平台中线前、后边缘骨折12例,单纯髁间隆突骨折7例,全平台粉碎性骨折27例.X线平片漏诊4例,CT更正X线分型9例.MPR可显示骨折内部的情况和平台塌陷的程度.3D成像可清晰显示胫骨平台骨折线的立体走行方向、关节面碎裂及平台塌陷的范围.结论 MPR和3D有助于胫骨平台骨折的分型,可准确测量劈裂和塌陷程度,为临床医师选择合理的治疗方案提供重要资料.

Usefulness of multiplanar and three-dimensional reconstruction of multislice spiral CT in diagnosis and treatment of tibial plateau fractures

Objective To probe value of multislice spiral CT(MSCT)multiplanar reconstruction(MPR)and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods Imaging data of 84 patients who were diagnosed and treated as tibial plateau fractures from June 2002 to September 2005 were retrospectively reviewed.Axial CT scan data were later processed with MPR and 3D reconstruction,and images were compared with X-ray plain films.Results Among 84 cases of tibial plateau fractures,36 showed lateral plateau fractures;2 showed medial plateau fractures;12 showed fractures in anterior and posterior edge of the plateau midline,7 showed simple fractures in intercondylar eminence;27 showed comminuted fractures in full plateau.4 cases of fractures were omitted by X-ray plain film,9 cases typed by X-ray plain film were corrected by findings from CT.MPR is able to show interior situation of frac-tures and extent of collapse of plateau.3D reconstruction can clearly display stereo anatomy of fracture line,broken articular surface and scope of collapse of the plateau.Conclusion MPR and 3D help to classify fractures in tibial plateau and to precisely measure cracks and collapses,contributing to planning a rational treatment.