螺旋CT三维重建(SSD、VRT)在髋臼骨折中的临床诊断价值:兼与X线、2DCT、MPR比较  

Clinical Application of Spiral CT to Acetabular Fracture: Surface Shaded Display (SSD) and Volume Rendering (VR) Techniques Study and Compared with Two- dimensional CT (2DCT),X-ray and MPR

作　　者：王劲[1] 张雪林[1] 李树祥[2] 郑卫权[1] 赵修义[1] 

机构地区：[1]第一军医大学南方医院影像中心,广东广州510515 [2]第一军医大学医工系全军重点图像处理室

出　　处：《实用放射学杂志》2003年第11期1006-1010,共5页Journal of Practical Radiology

摘　　要：目的　探讨螺旋CT三维表面遮盖法重建 (SSD)及容积重建技术 (VRT)显示髋臼骨折的诊断价值。方法　使用SIEMENSPLUS4螺旋CT机对 3 0例髋臼损伤患者进行扫描 ,在SIEMENS工作站进行SSD及VRT重建观察损伤细节 ,并与X线平片、二维CT(2DCT)、MPR比较。结果　 3 0例髋臼骨折 ,2DCT、MPR、VRT检查共发现了 169处骨折 ,X线发现 13 3处骨折 ,检出率是 78.7%。SSD发现 15 8处 ,检出率 93 .5 %。根据 2DCT扫描结果 ,经统计学分析 ,SSD、VRT检出骨折创伤量与X线、2DCT、MPR三者无显著性差异。3 0例髋臼骨折根据 2DCT按AO分类法分类 ,并经MPR、3DCT重建证实其分类 ,其中 2 2例经手术确诊 ,X线误诊 7例。 3DCT获得了髋臼骨折最直观、全面的图像。 12例进行了术后的 3DCT重建 ,VRT立体显示手术后骨盆及内固定物的形态、结构 ,SSD重建有时不能分辨内固定物和骨盆的形态、结构。结论　螺旋CTSSD及VRT是诊断髋臼骨折的有效手段 ,3DCT在骨盆及髋臼骨折分型中有重要的作用 ,对复杂性髋臼骨折的诊断应作为首选。Objective To evaluate the diagnostic value of three-dimensional SSD and VR techniques application to acetabular fracture.Methods 30 cases of acetabular trauma were examined with SIEMENS PLUS 4 spiral CT. These data were reconstructed in workstation with three-dimensional SSD and VR techniques, and then compared with the findings of X-ray, two-dimensional CT (2DCT) and MPR.Results For 30 cases of acetabular fractures, the fracture quantity of SSD and VRT was 158,169,while in X-ray plains,spiral CT and MPR was 133,169 and 169. Fracture detection rates of X-ray plains and SSD were 78.7% and 93.5%.The difference with spiral CT,MPR,VRT was not statistically significant of acetabular fractures. 30 cases of acetabular fractures were classified according to AO classification. MPR,3DCT had confirmed this classification, and 22 case had been identified through operation. X-ray misclassified seven cases. 3DCT might gain the most objective view of acetabular fractures. 12 cases of acetabular fracture were examined again post-operatively. Then the findings of postoperative were compared with that of pre-operative. The reconstructed images of VRT displayed the structure of acetabular fractures clearly, also showed the shape and location of the internal fixation and the effect of reposition after operation and the healing state of acetabular fractures. The images of SSD sometimes cannot tell the difference of the shape of structure of pelvis and internal fixation.Conclusion Three-dimensional SSD and VR techniques of spiral CT are effective methods in diagnosing acetabular trauma. 3DCT is an effective method in classifying acetabular fractures. And the imaging of SSD and VRT of spiral CT might provide exact guidance to formulating operative plan and choice of proper internal fixation, and is the first choice in examination of the complicated acutabular fracture. VR has the higher value in determine the location of the internal fixation and the effect of surgical reduction.

关 键 词：螺旋CT 三维重建 SSD VRT 髋臼骨折 诊断 X线 2DCT MPR 

分 类 号：R683.3[医药卫生—骨科学]