| 多层螺旋CT薄层扫描重建对寰枢椎骨折脱位的诊断和临床应用 |
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投稿时间：2008-11-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 华群 |
HUA Qun |
宁波市第六医院放射科,浙江 宁波 315040 |
Medical Imaging Department,the 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
lijuan301@nbip.net |
| 马维虎 |
MA Wei-hu |
宁波市第六医院骨科 |
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| 赵刘军 |
ZHAO Liu-jun |
宁波市第六医院骨科 |
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| 方媛 |
FANG Yuan |
宁波市第六医院放射科,浙江 宁波 315040 |
Medical Imaging Department,the 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年，第22卷，第5期，第349-352页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：采用多层螺旋CT薄层扫描及三维重建(3D)和多平面重建(MPR)技术诊断寰枢椎骨折脱位并进行术后效果评价。
方法：回顾性分析69例寰枢椎骨折脱位患者的手术前后X线片与多层螺旋CT薄层扫描及3D和MPR重建图像，其中男54例，女15例，年龄17～73岁，平均46.5岁。
结果：运用CT薄层扫描及重建技术诊断全部准确，其中齿状突骨折49例(AndersonⅡ型35例，Ⅲ型14例);C1,2联合骨折(Jeffson骨折联合Hangman骨折合并C1,2不稳)9例；寰椎爆裂骨折合并枕颈不稳6例；枢椎椎体骨折5例。而X线片诊断准确38例(38/69),漏诊23例，6例未能作出诊断，2例误诊。术后69例CT图像均清楚显示金属内固定的准确位置，其中2例螺钉螺纹轻微穿破寰枢椎侧块(椎弓根)外侧骨皮质，3例螺钉螺纹轻微穿破寰椎后弓上侧骨皮质。
结论：多层螺旋CT薄层扫描及重建能够直观清晰地显示寰枢椎骨折脱位的部位、类型及术后金属内固定位置，为临床确定骨折分型、选择合适的治疗方案和术后疗效评价提供了可靠而直观的依据，可作为寰枢椎骨折脱位的诊断和术后评价的影像学首选检查方法，应该常规使用。 |
| 【关键词】寰椎 枢椎 骨折 脱位 体层摄影术,螺旋计算机 三维重建 多平面重建 |
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| Clinical application of multi-spiral CT thinner scanning and reconstruction in the diagnosis of atlantoaxial fracture and dislocation |
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ABSTRACT
Objective: To evaluate the value of multi-spiral CT thinner scanning and three-dimensional and multi-planar reconstruction in the diagnosis of atlantoaxial fracture and dislocation.
Methods: Sixty-nine patients suffered from atlantoaxial injuries included 54 males and 15 females with an average age of 46.5 years ranging from 17 to 73. Roentgenograph, multi-spiral CT thinner scanning,three dimensional reconstruction(3D) and multi-planar reconstruction(MPR) were applied for patients before and after surgery.
Results: Multi-spiral CT thinner scanning and reconstruction provided clear images for all subjects. There were 49 odontoid bone fractures(Anderson typeⅡ 35,type Ⅲ 14),9 cases combined injuries of C1 and C2(Jeffson's fracture associated with Hangman fracture),6 of C1 burst fractures and 5 of C2 vertebral body fractures. While only 38 cases(38/69) were correctly diagnosed according to roentgenographs,23 missed diagnosis,6 couldn't be diagnosed clearly and 2 misdiagnosis. The position of internal fixation could be seen clearly in CT imaging after surgery. There were two screws perforated the lateral wall of C1 and three perforated the superior wall.
Conclusion: The multi-spiral CT thinner-scanning,three dimensional reconstruction(3D) and multi-planar reconstruction(MPR) provide clear imagings to diagnose the details of atlantoaxial fractures and dislocations,and to select the therapeutic regimen. It can also be used to check the position of the internal fixation after surgeries. So it can be the first eikonic choice for atlantoaxial injuries. |
| KEY WORDS Atlas Axis Fractures Dislocations Tomography,spiral computed Three dimensional reconstruction(3D) Multi-planar reconstruction(MPR) |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 华群,马维虎,赵刘军,方媛.多层螺旋CT薄层扫描重建对寰枢椎骨折脱位的诊断和临床应用[J].中国骨伤,2009,22(5):349~352 |
| 英文格式: | HUA Qun,MA Wei-hu,ZHAO Liu-jun,FANG Yuan.Clinical application of multi-spiral CT thinner scanning and reconstruction in the diagnosis of atlantoaxial fracture and dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(5):349~352 |
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