三维重建技术在胸腰椎爆裂骨折中应用.docVIP

三维重建技术在胸腰椎爆裂骨折中应用 　［摘 要］ 目的：探讨螺旋CT三维重建(ThreeDimensional Reconstruction ，3D)技术在胸腰椎爆裂骨折中的诊断及临床应用价值。方法：使用GE Hispeed 螺旋CT扫描机对87例脊椎损伤患者进行扫描，其中，男63例，女24例；年龄21岁～58岁，平均年龄36岁。全部数据输入Sun Space 20 工作站进行三维重建，并与X线平片、二维CT(2DCT)检查结果对照分析，所有图像由两位有经验的影像科医师采用双肓法进行评估。结果：将X线平片、2DCT、3DCT图像资料结合起来进行综合评估所得结果与X线平片合并2DCT图像评估相比较，在显示椎管内骨折片的数量方面，两者差异有显著性(χ2 =4.086, Plt;0.05)。多平面重建(MultiPlanar Reconstruction, MPR )能清晰地显示椎管内脊髓受压迫情况。结论：3D技术在胸腰椎爆裂骨折的诊断中具有重要价值，有助于临床医师选择手术方式，减少手术创伤和并发症。　　［关键词］ 脊柱骨折；体层摄影术；X线计算机；图像处理；计算机辅助 　　Helical CT Threedimensional Reconstruction for Evaluation of Thoraciclumbar Burst Fractures 　　Abstract：Objective To investigate the clinical value of helical CT threedimensional reconstruction in diagnosis of thoraciclumbar burst fractures. Methods 87 patients of spinal fractures, 63 males and 24 females with an average age of 36 years old were examined with GE Hispeed helical CT . All dates were sent to Sun Space 20 workstation. Images were reconstructed in workstation with threedimensional reconstruction, and then analyzed and compared with Xray film and 2DCT images. All of images were evaluated by two experienced radiologists with double blind method. Results On 3D images, the occurrence of fractures piece in the vertebral canal was higher than that on Xray film and 2DCT . There was significant difference between the two groups(χ2 =4.086, Plt;0.05). Multiplanar reconstruction clearly indicated the spinal cord compression status . Conclusion 3DCT has important value in the diagnosis of thoraciclumbar burst fractures. It is very helpful for the surgeons in the selection of operation method, as well as helpful for reducing operative injuries and complications. 　　Key words： Spinal fractures; Tomography; Xray computed; Image processing; Computerassisted 　　随着我国热器伤时代的到来，各类外伤患者日渐增多。胸腰段脊椎(T10~L2)处于两个生理弧度的交汇处，是应力集中之处，因此胸腰段脊柱骨折在临床上非常多见。胸腰椎爆裂型骨折多并发脊髓损伤，使患者严重致残或丧失生命。X线平片加常规CT扫描对胸腰椎爆裂型骨折部位的显示、骨折的分型、外伤性软组织血肿的显示以及脊柱的稳定性等有着重要的意义。为了更准确、直观、立体地显示损伤后的脊椎和脊髓，提供临床治疗更多的有指导价值的影像学信息，对胸腰椎骨折患者行螺旋