多层螺旋CT及其后处理技术对隐匿性骨折的诊断.docVIP

多层螺旋CT及其后处理技术在骨关节隐匿性骨折中的应用价值 刘芝美 (扬州友好医院放射科，江苏 扬州 225261) 摘要：目的：探讨多层螺旋CT及其后处理技术对骨关节隐匿性骨折的诊断价值。方法：回顾性分析46例X线平片漏诊，而后经多层螺旋CT薄层扫描并MPR及3D图像及患者资料。结果： 46例隐匿性骨关节骨折中，颈椎骨折4例，胸腰椎5例，肩胛骨2例，骨盆3例，膝关节5例，髋关节8例，踝关节5例，肋骨骨折9例，足骨4例，另外还有胸骨骨折1例。该组病例均经X线检查未发现明确骨折，后经多层螺旋CT及其后处理技术能清晰显示细微骨折的骨折线方向、骨碎块大小、移位程度及关节受累情况。结论：多层螺旋CT及其后处理技术能对骨关节隐匿性骨折做出准确诊断，并对临床治疗方案的选择及预后的评估有重要价值。 关键词：骨；隐匿性骨折；体层摄影术；X线计算机 Multi-slice spiral CT and its postprocessing techniques in application value of occult fracture of bone and joint LIU Zhi –mei （Yangzhou friendly hospital Radiology ，Yangzhou 225261 Jiangsu Province ，China） Abstract:Purpose：Study on multi-slice spiral CT and its postprocessing techniques in the diagnosis of occult fracture of bone and joint。Method： Retrospective analysis of 46 cases of missed diagnosis of x-ray, followed by thin layer scanning and MPR of multi-slice spiral CT and 3D images and patient information. Result： 46 cases of occult fractures of the bones and joints，4 cases of cervical spine fracture, Thoracic and lumbar spine in 5 cases, spealbone in 2 cases, pelvis in 3cases, Knee 5 cases, hip joint 6 cases, Ankles in 5 cases, 9 cases of rib fracture, Foot bones 4 cases，There is also 1 sternal fracture cases。The Group x-ray checks found no clear cases have been fractures, after multi-slice spiral CT and its postprocessing techniques clearly shows subtle fracture line size, bone fragments, and shift in the direction of fracture and joint involvement. Conclusion：Multi-slice spiral CT and its postprocessing techniques can make accurate diagnosis of occult fracture of bone and joint, and on the selection of the clinical treatment and prognostic evaluation of great value. Keyword：bone；occult fracture；Tomography；X-ray computed. 隐匿性骨折:是指用常规X线检查难以发现或者难以及时发现,经过一段时间或者用其他影像学方法才能发现的骨折[1]。VR技术是一投射线通过容积数据时所有像素总合的图像显示，利用了所有扫描信息，是一种较高形式的重建方式，并且能通过任意手工选择层面，任意方位进行切割和旋转，较为满意地显示出骨折线及移位情况[2]。 3.1 颈椎椎体 为不规则骨且寰枢椎周围结构重叠较多，X线平片不易显示骨折、脱位，CT轴位扫描能显示骨折但却不能良好显示颈椎序列及曲度的改变，MPR的冠状位、矢