64排螺旋CT在胫骨平台骨折分型及治疗方案选择中的应用  

Clinical application of 64-slice spiral CT in diagnosis and treatment of tibial plateau fractures

作　　者：畅宁[1] 杨志浩[1] 王利民[1] 高剑波[1] 张建军 

机构地区：[1]郑州大学第一附属医院,郑州450052 [2]许昌市中心医院骨科,河南许昌461000

出　　处：《医药论坛杂志》2011年第1期12-14,17,共4页Journal of Medical Forum

摘　　要：目的探讨CT及三维重建影像在胫骨平台骨折诊断和分型中的临床使用价值。方法 86例胫骨平台骨折患者均行X线平片和CT平扫及三维重建影像学检查,将术中所见与CT及X线片分型对比,分析CT三维重建影像在胫骨平台骨折诊断和分型中的作用。结果 87侧胫骨平台骨折病例中有18侧X线片诊断结果与CT不符,其中4侧无法确定诊断,14侧分型错误。10(10/18)侧更改内固定手术方法,占全部87侧骨折的11.49%。87侧经CT三维重建均获诊断分型,且与术中诊断符合。X线与CT分型符合率为79.3%。结论 CT三维重建影像能直观、立体地显示胫骨平台骨折的形态,对手术前的骨折分型、治疗方案制订以及手术入路选择有重要的指导意义。Objective To assess the clinical value of spiral CT with multi-functiional reconstruction in diagnosis and treatment of tibial plateau fractures.Methods Eighty-six cases of tibial plateau fractures were examined preoperatively under X-ray,CT scans and 3D-CT.Based on images,we classify the fracture,and compared the results of CT classification with results of X-ray and the discoveries in the operations,assessed the value in diagnosis and treatment of tibial plateau fracture.Results In total of 87 fractures,18 fractures had different results between X-ray and CT： four tibial plateau fractures was not found on X-ray films but on CT scans,the classification for 14 fractures was wrong.As a result,the initial internal fixation plan was changed for ten fractures of them（55.56%）.The classification coincidence between X-ray and CT was 79.3%.Conclusions 3D-CT reconstruction is a useful technique for the diagnosis and surgical planning of the tibial plateau fractures.

关 键 词：胫骨平台骨折 螺旋CT 多功能重建 治疗 

分 类 号：R816.8[医药卫生—放射医学]