螺旋CT三维重建和MRI在下颌骨髁突骨折中的临床应用比较  

Comparison of Spiral CT Three-Dimensional Reconstruction and MRI in Fracture of Mandibular Condyle

作　　者：雷欣 邓书海 关崧华 黄辉 陈玉婷 刘虹 LEI Xin;DENG Shu-hai;GUAN Song-hua;HUANG Hui;CHEN Yu-ting;LIU Hong(Department of Stomatology,Central Hospital of Longhua District of Shenzhen,Shenzhen 518110,China;Department of Stomatology,Nanhai Hospital Affiliated to Southern Medical University,Foshan 528200,China)

机构地区：[1]深圳市龙华区中心医院口腔科,广东深圳518110 [2]南方医科大学附属南海医院口腔科,广东佛山528200

出　　处：《口腔医学研究》2018年第7期746-750,共5页Journal of Oral Science Research

基　　金：佛山市自筹经费类科技计划项目(市医学类科技攻关项目)(编号:2017AB000232)

摘　　要：目的:探究螺旋电子计算机断层扫描(computed tomography,CT)三维重建和核磁共振(magnetic resonance imaging,MRI)在下颌骨髁突骨折中的诊断价值。方法:选择本院收治的69例疑似髁突骨折病例作为研究对象,患者均进行三维螺旋CT、MRI检测,观察患者髁突骨折类型、移位情况、软组织损伤情况,以患者术中诊断作为评定金标准,对比CT、MRI诊断髁突骨折类型、移位类型、软组织损伤诊断效能。结果:CT检测Ⅰ类骨折65.22%,Ⅱ类骨折21.74%,Ⅲ类骨折13.04%,MRI结果显示,Ⅰ类骨折占71.01%,Ⅱ类骨折占17.39%,Ⅲ类骨折占11.59%;CT检测骨折移位Ⅰ型39.13%,Ⅱ型28.99%,Ⅲ型31.88%;MRI检测Ⅰ型36.23%,Ⅱ型26.09%,Ⅲ型37.68%;CT、MRI骨折类型、移位类型检出对比无明显差异;MRI在骨髓水肿方面检出率明显高于CT(P<0.05)。以手术诊断作为评定金标准,MRI检测骨髓水肿准确度、灵敏度、特异度均明显高于CT(P<0.05)。结论:CT、MRI在检测髁突骨折类型以及骨折移位类型方面准确度均较高,两种影像学检测诊断价值相似,MRI还可有效反应患者关节囊内损伤情况,可用于下颌骨髁突骨折软组织损伤检测。Objective:To explore the diagnostic value of spiral CT three-dimensional reconstruction and magnetic resonance imaging(MRI)in the fracture of mandibular condyle.Methods:Sixty-nine cases of suspected condylar fracture that treated in our hospital were selected.All patients were detected by three dimensional spiral CT and MRI.The type,displacement,and soft tissue injury of the condylar fracture were observed.The intraoperative diagnosis was used as the gold standard of assessment.The diagnostic efficacy of CT and MRI in the diagnosis of condylar fracture type,displacement type,and soft tissue injury was compared.Results:CT detection showed thatⅠclass fracture was 65.22%,Ⅱclass fracture was 21.74%,andⅢclass fracture was 13.04%.MRI test results showed thatⅠclass fractures accounted for 71.01%,Ⅱclass fractures accounted for 17.39%,andⅢtype fractures accounted for 11.59%.CT detection showed the types of condylar fracture displacement typeⅠwas 39.13%,typeⅡwas 28.99%,and typeⅢwas31.88%.MRI showed typeⅠwas 36.23%,typeⅡwas 26.09%,and typeⅢwas 37.68%.There was no significant difference between the type of fracture and the type of displacement between CT and MRI.The detection rate of MRI in bone marrow edema was significantly higher than that of CT(P<0.05).Taken the operative diagnosis as the gold standard,the accuracy,sensitivity,and specificity of MRI in the detection of bone marrow edema were significantly higher than that of CT(P<0.05).Conclusion:The accuracy of CT and MRI in detecting the types of condylar fracture and fracture displacement types is similar.MRI can also effectively respond to intraarticular capsule injury in patients,and can be used to detect the soft tissue injury of the mandibular condylar fracture.

关 键 词：下颌骨髁突骨折 螺旋CT三维重建 核磁共振 骨折类型 骨折移位 诊断效能 

分 类 号：R782.4[医药卫生—口腔医学]