螺旋CT及后处理技术在足跗骨隐匿性骨折中的诊断价值分析定稿2送发表3.doc

螺旋CT及后处理技术在跗骨隐匿性骨折中的诊断价值 四川煤炭产业集团广能集团公司总医院（四川 广安 638500） 彭云 【摘要】目的：探讨螺旋CT后处理技术对足跗骨隐匿性骨折的诊断价值。方法 对62例外伤患者普通X线平片中未显示或仅可疑，而临床怀疑有骨折的患者进行SCT扫描后,通过特殊的CT图像处理软件包在工作站上进行后处理(MPR、MIP、VRT 及SSD) , 得到外伤部位骨骼高清晰度的二维和三维图像后, 由两位有经验的放射科医师共同阅片, 以共同意见为准。结果：62例外伤后，X线检查阴性或可疑足跗骨骨折的SCT扫描并重建后, 39例显示有骨折, 其中距骨（talus）骨折5例, 跟骨calcaneus骨折8例, 舟骨（navicular bone）骨折6例，楔骨cuneiform bone骨折11例, 骰骨cuboid bone骨折9例。结论：螺旋CT及后处理技术对临床怀疑足跗骨骨折而普通X线（DR）不能确诊为骨折的病例能准确地作出准确诊断, 当X线平片检查阴性或可疑跗骨骨折应及时行SCT检查。 关键词：跗骨（tarsal bones）骨折；隐匿性骨折；螺旋CT；图像后处理技术 The Value of Postprocessing Technique with Spiral CT in Diagnosis of the Tarsal Bones Occult Fracture Peng Yun Si Chuan Coal Group General Hospital，Guang An 638500，China [Abstract] Objective To evaluate the value of spiral CT (SCT) postprocessing reconstruction technique for the tarsal bones occult fracture. Methods SCT scans were performed in 62 patients who were suspected of tarsal bones fracture but negative or probable positive on X-ray film (including DR), and the images were post-processed 2D and 3D reconstruction (including MPR and VR) in workstation by using a specific CT postprocessing software package. The images were observed by two experienced radiologists. Results In 62 injuried patients, 39 cases were detected having patella fractures, in which 5 cases were talus fracture, 8 cases were calcaneus fracture ，6 cases were navicular bone fracture , 11 cases were tcuneiform bone fracture , 9 cases were cuboid bone fracture 。Conclusion SCT postprocessing reconstruction technique can make a definitely diagnosis in tarsal bones occult fracture and therefore should be applied to clinically suspicious cases. [Key words] Tarsal bones Fracture;Occult Fracture; Spiral CT;Postprocessing Technique 隐匿性骨折是指常规X线检查，包括传统的X线平片，CR、DR不能发现或仅疑似但不能确诊的骨折，多发生于解剖结构复杂部位，由于重叠投影的干扰，常规X线片不能发现此类骨折。足跗骨区域解剖结构相对复杂，重叠较多，常规X线检查对隐匿性细微骨折极易造成漏诊或误诊，延误治疗，甚至引起医疗纠纷（1）。而螺旋CT及其后处理技术被认为是早期发现隐匿性骨折的敏感而准确的方法，对临床诊断及治疗方法的选择起到了重要的指导作用。笔者旨在探讨螺旋CT及其后处理技术在足跗骨隐匿性骨折中的临床应用价值。 1 资料与方法