多层螺旋CT容积扫描后处理重建对骶尾椎隐匿性骨折的诊断价值  

Diagnostic value of post-process reconstruction technique with multi-slice spiral CT in occult fractures of sacrum and coccyx

作　　者：徐昌茶 吴茂铸 陶海慧 蔡卫东 

机构地区：[1]浙江省台州市路桥区中医院放射科,浙江台州318050 [2]浙江省台州恩泽医疗中心(集团)路桥医院放射科,浙江台州318050

出　　处：《中国医药导报》2014年第2期101-104,共4页China Medical Herald

基　　金：浙江省台州市路桥区第二批科技计划项目(编号2009C13020)

摘　　要：目的探讨多层螺旋CT(MSCT)容积扫描后处理重建技术对骶尾椎隐匿性骨折的诊断价值。方法对38例直接数字X线摄影(DR)检查后未发现骨折而临床怀疑有骶尾椎骨折的患者行MSCT容积扫描,通过ADW4.1工作站对容积数据进行多平面重建(MPR)、曲面重建(CPR)和容积再现(VR)等后处理重建,所有图像由2位高年资放射科医师共同阅读并评定。结果 38例DR未显示骨折的患者经MSCT扫描及后处理重建,检出隐匿性骶尾椎骨折33例,阳性率为86.8%(33/38),包括横行骨折14例,侧块骨折5例,近关节骨折6例,劈裂骨折3例,撕脱骨折5例,共累及42节椎体,5例患者排除骨折。二维重建(MPR/CPR)检出33例,检出率为100.0%,三维重建(VR)检出26例,检出率为78.8%,两者比较差异有统计学意义(χ2=5.75,P<0.05)。结论 MSCT容积扫描后处理重建能对骶尾椎隐匿性骨折准确地做出诊断,当X线平片检查阴性或可疑骶尾椎骨折时应及时行MSCT检查。Objective To investigate clinical value of post-process reconstruction technique with multi-slice spiral CT （MSCT） in diagnosis of occult fractures of sacrum and coccyx.Methods 38 patients suspected with sacrum and coccyx fracture but showed negative on digital radiography （DR） were given MSCT examination.The volume data was transferred to the ADW4.1 workstation and the image reconstruction including multi-planar reconstruction （MPR）,curved planar reformation （CPR） and volume rending （VR） were performed.All the images were observed by two experienced radiologists.Results DR showed no definite fracture signs in all patients.MSCT showed sacrum and coccyx fractures in 33 cases （86.8%,33/38）,with total number of the vertebral fractures were 42,including transverse fracture in 14 cases,side of the block fracture in 5 cases,adjacent joints fracture in 6 cases,splitting fracture in 3 cases,avulsion fracture in 5 cases.The other 5 patients showed negative on MSCT images.Two-dimensional reconstruction （MPR/CPR） showed all 33 cases of 33 fractures,the detection rate was 100.0%.Three-dimensional reconstruction （VR） showed 26 cases of 33 fractures,the detection rate was 78.8%,the difference was significant （x2=5.75,P 〈 0.05）.Conclusion The postprocess reconstruction technique of multi-slice spiral CT is more accurate in the diagnosis of occult fracture in sacrum and coccyx and therefore should be applied to clinical suspicious cases.

关 键 词：骶尾椎 隐匿性骨折 多层螺旋CT 后处理重建技术 

分 类 号：R683.2[医药卫生—骨科学]