MSCT图像重组技术在眼眶上、下裂骨折的应用价值  

Application value of of MSCT imaging reconstruction technique in SOF and IOF fracture

作　　者：邵举薇[1] 杨亚英[2] 向述天[1] 苏伟[1] 

机构地区：[1]云南省第二人民医院放射科,云南昆明650021 [2]昆明医科大学第一附属医院影像科,云南昆明650031

出　　处：《医学影像学杂志》2016年第11期1957-1961,共5页Journal of Medical Imaging

摘　　要：目的探讨多层螺旋CT(MSCT)图像重组技术在眼眶上、下裂外伤诊断中的临床应用价值。方法对临床初诊有眼眶外伤患者470例行MSCT常规轴位扫描,获取容积描数据后,在图像后处理工作站进行MPR、VRT重组,对各种重组结果进行回顾性对比分析。结果 MSCT骨折直接征象为骨皮质不连续、碎骨片移位,间接征象为鼻窦粘膜增厚共计41例,粘膜血肿征共计11例、鼻窦积血积液59例,眶下裂泪滴征24例及小空泡征2例。在98例眶上裂骨折中,轴位、轴位+MPR、轴位+VRT重建技术对骨折的显示率分别为86.7%、100%、97.9%,(Χ~2值/P值轴位*轴位+MPR-13.923/0.000、Χ~2值/P^(值轴位*轴位+VRT)-8.735/0.003),差异有统计学价值。在59例眶下裂骨折中,轴位、轴位+MPR、轴位+VRT重建技术对骨折的显示率分别为81.4%、100%、94.9%,(Χ~2值/P值轴位*轴位+MPR-12.131/0.000、Χ~2值/P^(值轴位*轴位+VRT)-5.187/0.023),差异有统计学价值。结论多层螺旋CT轴位结合MPR、VR重建图像能辨析解剖形态,准确显示眶上裂、眶下裂骨折的分型、范围、程度,轴位+MPR显示率最高,多种重建技术能为临床诊断和治疗提供可靠的影像诊断依据。Objective To explore the value of imaging reconstruction techniques of multi-slice spiral CT（MSCT） in Superior orbital fissure （SOF） and Inferior orbital fissure （IOF） fracture. Methods 470 cases clinically diagnosed as the orbital injuries underwent CT plain scan. The data were processed with multiple Multiplanar reconstruction （MPR） , volume rendering technique （VRT） and then retrospectively reviewed. Results The direct CT signs of OC fractures included continuous interruption of bone cortex, and displacement of fragments. The indirect signs included thickening mucous membrane of paranasal sinus in 41 cases, localized hematoma of mucous membrane in 11 cases, effusion of paranasal sinus in 59 cases, teardrop sign of IOF in 24 cases, and small vacuole sign in 2 cases. In 98 cases with SOF fracture, the detection rate of axial view, axial view with MPR and axial view with VRT reconstruction technique were 86. 7%, 100%, and 97. 9% （χ^2/P^axial＊axial＋MPR-13. 923/0. 000,χ^2/P^axial＊axial ＋VRT-8.735/0. 003） respectively; the difference was statistically significant. In 59 cases with IOF fracture, the detection rate of axial view, axial view with MPR and axial view with VRT reconstruction technique were 81.4% , 100% and 94. 9% , （ χ^2/P^axial＊axial＋MPR-12. 131/0. 000, χ^2/P^axial＊axial ＋VRT-5.187/0. 023 ） respectively ; the difference was statistically significant. Conclusion MSCT scan and MPR, VRT reconstruction can definite anatomic forma and provide a more accurate understanding of the scope, degree and type of SOF and IOF fracture. HRCT axial view in combination with MPR has the best detection rate. Application of multiple techniques can provide a reliable imaging basis for clinical diagnosis and treatment.

关 键 词：眶上裂 眶下裂 眼眶骨折 体层摄影术 X线计算机 

分 类 号：R683.5[医药卫生—骨科学] R814.42[医药卫生—外科学]