多层螺旋CT重建技术在检出颅底骨折和骨折损伤程度评估中的临床意义  

Clinical significance of MSCT reconstruction techniques in assessment of bone fractures and fracture damage degree of skull base

作　　者：于朝旭[1] 孙实安[1] 张海军[1] 

机构地区：[1]河北省承德市中心医院神经外科,河北承德067000

出　　处：《实用医院临床杂志》2017年第6期131-133,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨多层螺旋CT(MSCT)三维后处理重建技术对颅底骨折的检出情况和孔道累及情况,评估颅底骨折损伤程度的准确性。方法我院2013年1月至2017年5月具有明确外伤史,行MSCT检查并诊断为颅底骨折的80例患者,利用计算机软件对原始数据进行三维重建后处理,将颅底损伤程度共分为4级,对比不同重建技术对颅底骨折的检出情况和孔道累及情况,评估颅底骨折损伤程度的准确性。结果多平面重组(MPR)重建层面对颅底骨折的显示率明显高于容积再现技术(VR)与表面遮盖显示技术(SSD)(P<0.05)。MPR对颅底骨折的显示情况与原始二维横断面比较差异无统计学意义(P>0.05)。在了解圆孔、卵圆孔、棘孔及视神经管受累情况时,MPR明显高于原始横断面、VR和SSD重建技术(P<0.05);横断面、MPR、VR及SSD等在枕骨大孔受累检查中差异无统计学意义(P>0.05);横断面在检出颈动脉管受累情况时明显高于MPR、VR和SSD三维后处理技术(P<0.05)。原始横断面对评估0级和3级损伤程度患者的准确率明显高于MPR、VR和SSD;对评估1级和2级损伤程度患者的准确率明显高于VR和SSD(P<0.05)。结论 MSCT三维重建后处理技术在颅底骨折的检出及孔道累及情况方面具有明确的优势,将原始横断面与三维后处理技术相结合能够提高颅底骨折检出率、了解孔道累及情况和颅底骨折损伤程度,为临床的治疗及预后提高极为重要的图像信息。Objective To explore the detection of the fracture of the skull base and channel involvement by using 3-demension reconstruction technique of MSCT and evaluate the accuracy of fracture damage degree. Methods Eighty patients from January 2013 to May 2017 in our hospital were involved in the study. The patients with clear history of trauma were diagnosed as fracture of the skull base by MSCT. We used computer software to perform the 3-demension of reconstruction of the original data, and then divided the damage degree of the skull base fracture into 4 classifications. The detection efficiency of the skull base fracture and channel involvement were compared among the different reconstruction technology to evaluate the accuracy. Results The show rate of MPR reconstruction was significantly higher than that of VR and SSD （ P 〈 0. 05 ）. There was no significant difference in display of the fracture of the skull base between the MPR and the original 2-dimensional cross section （ P 〉 0. 05 ）. In the understanding of round hole, patent foramen, foramen spinosum and optic canal involvement situations, MPR was superior to the original cross-section as well as VR and SSD reconstruction technology （P 〈 0. 05 ）. The difference in the exploring the occipital foramen was not statistically significant among the crosssection, MPR, VR and SSD （ P 〉 0.05 ）. The detection efficiencY of carotid artery involvement of the cross-section was significantly higher than that of MPR, VR and SSD （P 〈 0. 05 ）. The accuracy of the original transect in evaluation of the damage degree from 0 to 3 was significantly higher than that of MPR, VR and SSD （ P 〈 0. 05 ）. The accuracy of the original transect in evaluation of the 1-2 damage degree was significantly higher than that of VR and SSD （ P 〈 0.05 ）. Conclusion The 3-dimensional reconstruction of MSCT post-processing technique has a clear advantage in the detection of the fracture of the skull base and channel involvement. Combination of the original cros

关 键 词：颅底骨折 三维重建 CT 

分 类 号：R814.42[医药卫生—影像医学与核医学] R683.5[医药卫生—放射医学]