双排螺旋CT三维重建在视神经管骨折检查中的价值研究  

Value Study of Double-Row Spiral CT Three-Dimensional Reconstruction in Examination of Optic Canal Fracture

作　　者：何中虎 朱智生 He Zhong-hu;Zhu Zhi-sheng(Department of Radiology,Zhongxin Town Central Health Center of Zengcheng District,Guangzhou 511365,Guangdong Province,China)

机构地区：[1]广州市增城区中新镇中心卫生院放射科,广东广州511365

出　　处：《中国社区医师》2022年第27期96-98,共3页Chinese Community Doctors

摘　　要：目的:探讨双排螺旋CT三维重建在视神经管(OC)骨折检查中的价值。方法:选取2018年2月-2020年2月于广州市增城区中新镇中心卫生院确诊并接受治疗的46例OC骨折患者作为研究对象,均行常规CT检查与CT三维重建。观察患者的OC骨折情况、分型情况、不同CT重建方式显示不同类型OC骨折的情况以及影像学表现。结果:46例患者中共50眼发生OC骨折,4例为双侧OC骨折,27眼(54.0%)为左侧OC骨折,23眼(46.0%)为右侧。26眼(56.5%)为单壁OC骨折,24眼(43.5%)为多壁OC骨折。50眼OC骨折中,12眼(24.0%)为线状型骨折,17眼(34.0%)为凹陷型骨折,7眼(14.0%)为嵌入型骨折,10眼(20.0%)为粉碎型骨折,4眼(8.0%)为混合型骨折。CT三维重现显示凹陷型骨折及嵌入型骨折的概率高于常规CT检查,差异有统计学意义(P<0.05);两种CT重建方式对线状型骨折、粉碎型骨折及混合型骨折的显示率比较,差异无统计学意义(P>0.05)。直接CT检查征象表现:OC壁骨质出现骨片分离、粉碎或者连续性的中断,其中有6例合并OC狭窄,14例合并OC变形。间接CT检查征象表现:36例蝶窦当中出现密度增高影,27例在筛窦当中出现密度增高影,4例合并眶内血肿,10例视神经显著迂曲、增粗。结论:给予OC骨折患者双排螺旋CT三维重建,能够从不同角度对OC骨折进行直观观察,特别是骨折明显移位时,可有效显示空间关系及骨折形态。但是当骨折较小移位时,难以进行全面显示。Objective:To investigate the value of double-row spiral CT three-dimensional reconstruction in the examination of optic canal(OC)fracture.Methods:A total of 46 patients with OC fractures diagnosed and treated by Zhongxin Town Central Health Center in Zengcheng District of Guangzhou City from February 2018 to February 2020 were selected as the study subjects,and all patients received routine CT examination and CT three-dimensional reconstruction.The OC fractures,the classification of OC fractures,different types of OC fractures displayed by different CT reconstruction methods,and imaging findings of all patients were observed.Results:OC fractures occurred in 50 eyes of all 46 patients,4 cases had bilateral OC fractures,27 eyes(54.0%)had left OC fractures,and 23 eyes(46.0%)had right OC fractures.26 eyes(56.5%)had single-walled OC fractures and 24 eyes(43.5)had multi-walled OC fractures.Among the 50 eyes with OC fractures,12 eyes(24.0%)had linear fractures,17 eyes(34.0%)had concave fractures,7 eyes(14.0%)had embedded fractures,10 eyes(20.0%)had comminuted fractures,and 4 eyes(8.0%)had mixed fractures.CT three-dimensional reconstruction showed a higher ratio of concave and embedded fractures than conventional CT examination,and the difference was statistically significant(P<0.05);There was no significant difference in the display rates of linear fracture,comminuted fracture and mixed fracture between the two CT reconstruction methods(P>0.05).Direct CT examination signs showed bone fragment separation,pulverization or continuous interruption of OC wall bone,of which 6 cases had OC stenosis and 14 cases had OC deformation.Indirect CT examination signs showed increased density shadow in 36 cases of sphenoid sinus and in 27 cases of ethmoid sinus,concurrent intraorbital hematoma in 4 cases,and significant tortuosity and thickening of the optic nerve in 10 cases.Conclusion:The use of double-row spiral CT three-dimensional reconstruction for patients with OC fractures can visually observe OC fractures from different angles

关 键 词：视神经管 骨折 双排螺旋CT三维重建 

分 类 号：R779.1[医药卫生—眼科]