CT在髋臼骨折诊治中的应用价值  

The clinical value of CT diagnosis and treatment in acetabular fractures

作　　者：蒲红[1] 白林[1] 付凯[1] 赵世煜[1] 陶克言[1] 

机构地区：[1]四川省人民医院CT室,四川成都610072

出　　处：《中国临床医学影像杂志》2001年第1期43-45,51,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：分析髋臼骨折 CT及三维重建表现，探讨其临床应用价值。材料与方法： 50例髋臼骨折均摄 X线平片及 CT横断扫描，其中 45例采用 SSD(表现遮盖法 )或 MPR(多平面重建 )技术作三维重建。分析 50例髋臼骨折的横断及三维重建 CT表现，根据 Letournel分型将其分类，重点探讨三维重建的应用价值。结果： 50例髋臼骨折中，①简单骨折 22例，其中前壁骨折 5例，前柱骨折 3例，后壁骨折 6例，后柱骨折 4例，横行骨折 4例， X线平片仅显示 19例骨折。②复杂骨折 28例，其中双柱骨折 9例， T型骨折 4例，后柱伴后壁骨折 6例，前柱伴后半横行骨折 4例，横行伴后壁骨折 5例。 CT横断扫描共显示关节腔内骨折碎片 54块， X线平片仅显示关节腔内骨折碎片 32块，并清楚显示软组织损伤情况。三维重建图像多角度、立体显示骨折及移位情况。 50例髋臼骨折中， 38例行手术治疗， 12例保守治疗。手术中所见与 CT扫描结果完全一致。结论：髋臼骨折 CT扫描能准确对骨折分型，三维重建可弥补横断影像的不足，有助于骨折的立体定位，对治疗方案的选择及预后提供客观依据。Objective:To evaluate CT and three－ dimensional(3D) CT imaging reconstruction findings of acetabular fractures and study its clinical applications.Materials and Methods:To study CT and 3D CT findings of 50 cases acetabular fractures,X－ ray plain film and CT was done at 50 cases of acetabular fractures.3D imaging Reconstruction was done at 45 cases acetabular fractures with SSD(Shaded Surface Display)or MPR(Multiplanar Reconstruction)methods.CT and 3D CT finding analysis was done according to letournel classification.Clinical applications of 3D CT imaging Reconstruction was studied emphasize.Results:The results showed that there were① 22 cases simple fractures,includes:5 cases of the anterior wall,3 cases of the anterior column,6 cases the posterior wall,4 cases of the posterior column,4 cases of the transverse.X－ ray plain film showed only 19 cases.② 28 cases complex fractures,includes:9 cases the double column,4 cases the T－ shaped,6 cases of the posterior column and posterior wall,4 cases of the anterior column and a hemi－ transverse fractures line posteriorly,5 cases of the transverse and posterior wall.CT scans show the osseous fragment in joint that could not be detected at plain film.The soft－ tissue damage was also revealed.3D imaging Reconstruction show the fractures from multiangular and three－ dimensional.Surgical operation was performed in 38 cases acetabular fractures,and the CT results was same as the surgical operation in 38 cases.12 patients were treated nonoperatively.Conclusion:Acetabular fractures can be correctly classify with CT scans.Shortage of sequence imaging can be supply by 3D CT Reconstruction and provide evidence on choosing therapeutic methods and evaluating prognosis.

关 键 词：髋臼 骨折 CT 诊断 治疗 

分 类 号：R683.3[医药卫生—骨科学]