多层螺旋CT三维重建在颌面骨折中的应用

目的 探讨多层螺旋CT三维重建成像在颌面骨折中的临床应用价值。方法 对38例颌面骨折患者行多层螺旋CT扫描，层厚1mm或2mm，在此基础上进行骨密度三维重建和多平面重建，用不同的旋转轴观察不同角度骨折的三维病变图像，对获取的图像进行分析并与X线平片对照。结果 多层螺旋CT三维重建成像再现了颌面骨折的病理解剖全貌，38例均能清晰直观地显示颌面骨折的部位、骨折线走向及骨折移位的方向和程度。据此分别制定和实施相应的治疗方案，其中33例行切开复位坚强内固定，5例采用保守疗法，治疗后咬合功能及面部外形均恢复正常。结论 多层螺旋CT三维重建有助于理解颌面骨折的三维立体形态和复杂的病理解剖关系，为拟定治疗方案提供有价值的信息。

The value of clinical application of three-dimensional spiral CT on the maxillofacial fractures

Objective To evaluate the clinical application of the three-dimensional (3D) spiral CT on the maxillofacial fractures. Methods A total of 38 patients with maxillofacial fractures underwent multislice spiral CT with a slice thickness of 1-2mm. The 3D reconstruction and the multi-planar reconstruction (MPR) were used for these maxillofacial fractures.The 3D CT images of maxillofacial fractures were obtained in different rotating plane,which were analyzed and compared with the x-ray plain films. Results The 3D CT reconstructed an overall perspective of the pathological anatomy of maxillofacial fractures,and clearly demonstrated the location and moving condition of the fractures.Totally 38 patients,33 undergoing open reduction and firm fixation,and 5 using non-surgical method, achieved satisfactory occlusion and appearance after treatment with the help of 3D CT images. Conclusion The 3D CT images of maxillofacial fractures,being able to improve the understanding of 3-dimensional morphology and the anatomy of maxillofacial fractures,serve as a primary guide in surgical or non-surgical planning.