三维CT成像诊断髁突骨折的临床研究  

Clinical Study of Three-dimensional Reconstruction of Computed Tomography in Diagnosis of Condylar Fractures

作　　者：吴汉江[1] 罗建光[2] 朱兆夫[1] 

机构地区：[1]湖南医科大学附属第二医院口腔科,410011 [2]湖南医科大学附属第二医院放射科,410011

出　　处：《华西口腔医学杂志》2000年第1期42-44,共3页West China Journal of Stomatology

摘　　要：目的 :探讨获得高质量颞颌关节三维CT影像的方法 ,评价其对髁突骨折的诊断价值。方法 :对 14例髁突骨折患者 ,采用 3种扫描方式 (横断、冠状、螺旋 ) ,2种扫描范围 (横断位 :眶耳平面上方 1cm至下颌升支中份或颏下点。冠状位 :乳突至下颌升支前缘或颏前点。)和 2种层厚 (2 5mm、5 0mm)扫描 ,以勾画法删除层面影像中的颈椎、茎突、枕骨和部分乳突 ,表面阴影显示法 (SSD)完成三维重建。结果 :2 5mm薄层横断扫描获得的三维重建影像质量最佳 ,勾画删除技术的应用有利于消除颈椎等对骨折观察的影响。 14例患者检出髁突骨折 2 1侧 ,骨折部位、髁突移位情况显示理想。结论 :薄层横断扫描配合勾画删除技术 ,可获得高质量三维重建影像 ,准确、直观地显示髁突骨折情况。Objective: To explore a method of getting good three dimensional (3D) reconstraction images of temporomandibular joint (TMJ) by computed tomography (CT), and evaluate diagnosis value of 3DCT in condylar fractures. Methods: Of the 14 patients studied, 12 were male and 2 were female with age ranging from 4 to 37 years old. 4 were old fractures and the other 10 were fresh fractures. All patients′ orthopanotomograms were taken first, and then were scanned with CT. The scanning conditions were 300～345 mAS and 120kV, and the canning methods included cross sectional (11/14), coronal sectional (2/14) and spiral (1/14) (pitch:1, thickness of layers:2 5 mm) scanning. Scanning scopes: The cross sectional and spiral scanning were from 1 cm above the Frankfort horizontal plane to the middle of the mandibular ramus or Menton; The coronal sectional scanning was from the mastoid process to the anterior point of the mandibular ramus or Pogonion. The thickness of the scanning layers was 2 5 mm (12/14) or 5 mm (2/14). Finally, 3D reconstructed images were obtained by shaded surface display (SSD). The cross sectional images were obtained by being removed the cervical vertibra, the styloid process, the occipital bone and part of the mastoid process with Subtract Manual Irroi before reconstruction to avoid interference with the observation of TMJ and skull basis. Results: ①The best 3D CT reconstructed images were obtained by 2 5mm thin layer cross sectional scanning by being removed parts of the adjacent structures, and the bone lines were clear and smooth without adjacent bone structures shading TMJ. The quality of images taken spirally was similar to those taken cross sectionally. While the coronal scanning neglected some important anatomic symbols which might be valuable to diagnose condylar displacement. ②Of the 14 patients, 7 were unilateral condylar fractures and 7 were bilateral (21 sides altogether), among which 18 sides were high fractures of condyles and 3 were fractures of condylar neck. High oblique li

关 键 词：髁突骨折 三维重建 CT 诊断 

分 类 号：R816.98[医药卫生—放射医学]