多层螺旋CT扫描三维重建在颌面部骨折诊断和治疗中的应用价值  

The application value of multi-slice spiral CT scan 3D reconstruction in the diagnosis and treatment of maxillofacial fractures

作　　者：彭明[1] 石永久[1] 张佳文[1] 肖新华[1] 

机构地区：[1]广东省深圳市宝安区中医院集团影像科,广东深圳518100

出　　处：《医学影像学杂志》2017年第4期608-610,共3页Journal of Medical Imaging

摘　　要：目的探讨多层螺旋CT扫描三维重建在颌面部骨折诊断和治疗中的应用价值。方法将2014年3月~2015年3月我院收治的35例颌面部骨折患者作为研究对象,患者在术前均行螺旋CT扫描检查,行二维及三维图像处理,并将两种图像处理结果与术后所见结果进行对照分析,比较两种图像处理结果的优缺点。结果 35例颌面部骨折患者采用螺旋CT二维重建和三维重建处理均可以良好显示颧骨骨折、鼻骨骨折以及上、下颌骨骨折,在骨折移位和骨折线走行上螺旋CT三维图像处理结果明显优于螺旋CT二维图像处理结果;螺旋CT二维横断位图像可以全部显示蝶骨、筛骨以及颚骨骨折,而螺旋CT三维图像则只可以显示部分骨折,效果差于二维图像。结论对于颌面部骨折,采用螺旋CT二维图像仍是当前最基本的诊断方式,采用螺旋CT三维重建可以全面准确地显示颌面部骨折骨线和骨块移位的空间解剖关系,在指导手术设计和提高手术治疗效果方面具有重要价值。Objective To discuss the application value of multi-slice spiral CT scan 3D reconstruction in the diagnosis and treatment of maxillofacial fractures. Methods 35 cases of maxillofacial fractures were used spiral CT two-dimensional reconstruction and 3D reconstruction, which could well display the zygomatic fracture and nasal bone fractures and mandibular fracture, fracture displacement and fracture in line. Spiral CT 3D image processing results were superior to spiral CT two-dimensional image processing results, the two image processing results and the results after the operation were compared and analyzed, the advanta- ges and disadvantages of two kinds of image processing results were compared. Results 35 jaw fracture patients were used spiral CT two-dimensional reconstruction and three-dimensional reconstruction processing, which could show the fracture of the bone , nasal bone fracture, upper and lower jaw fractures. Spiral CT scan 3D imagining dealing result on fracture displacement and fracture line was significantly better than that of spiral CT scan 3D imagining dealing; Spiral CT 2D axial images could show all the sphenoid ethmoid maxillary fracture, while the spiral CT three-dimensional images could only show part of the fracture, effect was worse than that of two-dimensional images. Conclusion For maxillofacial fractures, the use of spiral CT two-dimensional image is the most basic diagnostic method. Using spiral CT 3D reconstruction, we can completely and accurately display space anatomical relationship of the bone and bone block displacement in the maxillofacial fractures, which has important value in guiding the design and improving the surgical treatment effect.

关 键 词：体层摄影术 X线计算机 颌面部骨折 诊断价值 三维重建 

分 类 号：R782.4[医药卫生—口腔医学] R445.3[医药卫生—临床医学]