多层螺旋CT三维重建在胸部外伤骨折中的应用价值  

The value of MSCT with three dimensional reconstruction in chest trauma fractures

作　　者：黄崇权[1] 张丽敏[1] 斯洋[1] 徐立文[1] 郑文龙[1] 洪瑞镇[1] 

机构地区：[1]浙江省温州市第二人民医院CT室,浙江温州325000

出　　处：《医学影像学杂志》2009年第3期278-281,共4页Journal of Medical Imaging

摘　　要：目的:探讨多层螺旋CT三维重建在胸部外伤骨折中的应用价值。方法:分析30例胸部外伤骨折的病例,全部病例均行X线检查、多层螺旋CT扫描与三维重建容积再现法(VR)、多平面重建(MPR),观察和分析骨折的位置、数量及邻近组织、脏器的情况。结果:30例胸部外伤病例,MSCT检查共发现肋骨骨折19例(50处),肋软骨骨折3例(7处),胸骨骨折12例(14处),肩胛骨骨折7例(10处)。轴位图像、MPR重建能清晰地显示出骨折及断端移位情况,结合VR重建,肋骨骨折的位置、数目的显示均较确切;另外还发现肺挫伤13例,血胸20例,气胸7例;肝脏、脾脏挫裂伤各1例;胸骨骨折合并胸骨旁、前纵隔血肿8例。X线平片共发现肋骨骨折35处、肋软骨骨折0处、胸骨骨折1处、肩胛骨骨折6处;X线平片仅发现肺挫伤5例,血气胸10例;X线平片和MSCT同时发现锁骨骨折2处、胸椎骨折2处。结论:多层螺旋CT轴位图像、MPR及VR三维重建的联合应用,对判断胸部外伤骨折及邻近组织、脏器损伤有很高的诊断价值,明显优于常规X线检查,尤其对临床可疑肋骨骨折及肋软骨、胸骨骨折是一种重要的补充检查手段。Objective：To evaluate the diagnostic value of three dimensional reconstruction of muhislice spiral CT （MSCT） in chest trauma fractures. Methods：30 patients of chest trauma fractures were examined by X-ray, Mscr, volume rendering （VR） of three dimensional reconstruction and, multiplanar reconstruction（MPR）, the position, numbers, adjacent tissues and organs of fractures were observed and analyzed. Results：50 fractures in 19 rib fracture cases, 7 fractures in 3 costobrachial fracture cases, 14 fractures in 12 sternal fracture cases, and 10 fractures in 7 shoulder blade fracture cases were found in the 30 chest tratmla fractures by MSCT. Axial images and the reconstruction of MPR Could clearly display fractures and displacement of fractured ends. Combined with the reconstruction of VR, the position and numbers of rib fractures were also showed clearly, with 13 pulmonary contusion cases, 20 hemothorax cases, 7 pneumothorax cases, 1 liver contusion case, 1 spleen contusion case, 6 shoulder blade fractures, 8 sternal fracture cases combined with parastemal and mediastinal hematoma. 35 rib fractuers, 1 sternal fracture, 6 shoulder blade fractures and none of costobrachial fracture, 5 pulmonary contusion cases, and 10 hemopneumothorax cases were found by X-ray plain film. 2 clavicle fractures, 2 vertebral fractures were found by X-ray plain film and SMCT. Conclusion：The combination use of axial imagine of MSCT, MPR and three dimensional reconstruction of VR is of high value in the diagnosis of trauma of chest fractures and the adjacent tissues and organs, much better than X-ray, especially for fib fracture, costobrachial fracture and sternal fracture.

关 键 词：胸部外伤 骨折 体层摄影术 X线计算机 三维重建 

分 类 号：R683.1[医药卫生—骨科学] R814.42[医药卫生—外科学]