复杂桡骨远端骨折多维重建的应用价值  

Two-and Three-dimensional Evaluation of Complex Fractures of the Distal Radius with Spiral Computed Tomography

作　　者：张亚东[1] 邵康为[2] 曹得良[1] 杨冰[1] 周秦仁[1] 

机构地区：[1]上海市长宁区中心医院骨科,200336 [2]上海市长宁区中心医院6CT室,20033

出　　处：《骨与关节损伤杂志》2001年第6期401-403,共3页The Journal of Bone and Joint Injury

摘　　要：目的　探讨复杂桡骨远端骨折多维重建 (表面遮盖法及多层面重组 )的临床应用价值。方法　对 32例石膏固定X线复查累及关节面的复杂桡骨远端骨折患者 ,用GE螺旋CT (SCT)按扫描层厚 1～ 2mm ,重建间隔 0 . 5～ 1mm ,螺距 1. 0～ 1.5mm ,采集容积数据后多层面重组 (MPR)及表现遮盖法重建 (SSD) ,将重建结果与X线平片对比观察。采集容积数据时分别运用了横断、冠状及矢状位患腕扫描方式 ,并比较之不同。结果　与X线平片比较 ,复杂桡骨远端骨折多维重建可立体观察骨折的位置 ,骨折线的走向 ,骨折块的大小、多少 ,特别是关节面伤后的形态 ,检出X线阴性的腕骨骨折 4例 ,有关节面塌陷 7例。结论　不同扫描方式各有其特点 ,但一般以冠状位首选。复杂桡骨远端骨折螺旋CT多维重建弥补了X线平片不足 。Objective To discuss the clinical value of spiral computed tomography in revealing details of complex fractures of the distal radius with 2 and 3 dimensional (MPR and SSD) reconstruction.Methods Thirty two cases of intraarticular fracture of the distal radius were stabilized with plaster, and scanned with GE sprial CT scanning We used the 1 to 2 mm slice thickness, reconstruction at 0.5 to 1 mm, and a pitch of 1.0 to 1.5 mm.Multiplanar reconstruction (MPR) and surface shaded display (SSD) were generated and comparable with the X ray films. Patients wrist were scanned by axial, sagittal, coronal planes respectively for comparing them.Results MPR and SSD were better than X ray films at demonstratiating fractures, the extent of articular depression and fracture involvement of the distal radioulnar joint. Four wrist bone fractures and five depressed articular fractures, which were not found by X ray films, were discovered.Conclusion In general, we at first chose coronal scan methods. MPR and SSD compensated for the limit of X ray films, provided the more informations about complex intra articular fractures in chosing the operative fixation instruments, designing operative approach, evaluating the prognosis.

关 键 词：腕关节 骨折 图像处理 桡骨骨折 CT X线诊断 

分 类 号：R683.41[医药卫生—骨科学]