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螺旋CT重建技术在骨盆环骨折中的诊治价值
Hits: 2475   Download times: 1696   Received:December 16, 2009    
作者Author单位UnitE-Mail
李飞鹏 LI Fei-peng 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 nbly.lfp.2008@163.com 
李明 LI Ming 宁波市第六医院骨科  
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  
赵刘军 ZHAO Liu-jun 宁波市第六医院骨科  
罗建宁 LUO Jian-ning 宁波市第六医院骨科  
期刊信息:《中国骨伤》2010年23卷,第3期,第204-207页
DOI:10.3969/j.issn.1003-0034.2010.03.018


目的:探讨螺旋CT二维多平面重建(MPR)、三维重建(3D)对骨盆环骨折的诊断、分型及治疗的临床价值。

方法:回顾性分析2004年4月至2009年4月收治的有完整的X线DR(digital radiography)片、螺旋CT片影像资料的57例骨盆环骨折患者,根据Tile 分类,本组病例A型38例,B型12例,C型7例。对A型患者采取保守治疗,对B、C型患者全部采取手术治疗,根据骨折移位情况,采用开放复位内固定或经皮行骶髂关节空心螺钉内固定术。术后3 d~27个月内进行随访,利用螺旋CT检查进行术后疗效评估,对其术前术后的DR片、螺旋CT的3D、 MPR的重建图像进行对照分析。

结果:57例骨盆环骨折患者中,5例骨盆后环骨折患者的X线DR片诊断为可疑骨折,9例骨盆后环骨折X线DR片漏诊,3例骨盆前环骨折患者的X线DR片诊断为可疑骨折,3例骨盆前环骨折患者的X线DR片漏诊,后经螺旋CT检查予以修正。术后影像学评价优15例,良3例,差1例;临床评价优16例,良3例。

结论:螺旋CT的MPR、3D的重建图像对骨盆环骨折的诊断、分型及临床治疗评估具有重要的临床价值。
[关键词]:骨盆  骨折  体层摄影术,螺旋计算机  诊断  骨折固定术,内
 
Study on the spiral CT reconstruction in the diagnosis and treatment of pelvic ring fractures
Abstract:

Objective: To investigate the clinical value of spiral CT with multi-planar reconstruction(MPR) and three diamensions reconstruction(3D) in the diagnosis and treatment of pelvic ring fractures.

Methods: Fifty-seven patients with pelvic ring fractures were examined with digital radiography and spiral CT in our hospital from April 2004 to April 2009. According to Tile classification,there were thirty-eight cases in type A,twelve in type B and seven in type C. Expectant treatment was used in type A,while surgery,open reduction internal fixation or percutaneous lag screw internal fixation technique for sacroiliac joint due to the displacement of fractures,for type B and C. Three days to twenty-seven months after operation,spiral CT examinations were used to evaluate the location of internal fixation. Cross-check analysis of images of digital radiography and spiral CT was performed before and after operation.

Results: Five posterior and three anterior pelvic ring fractures were diagnosed as suspected fractures. Nine posterior and three anterior pelvic ring fractures were missdiagnosed according to plain radiographs,which were corrected by spiral CT examination. According to the postoperative imageology evaluation,the Results were excellent in 15,good in 3 and bad in 1. According to clinical evaluation,16 cases were excellent,3 good.

Conclusion: Spiral CT with multi-planar reconstruction(MPR) and three diamensions reconstruction(3D) has clinical values for precise diagnosis and treatment for the complex pelvic ring fractures.
KEYWORDS:Pelvis  Fractures  Tomography,spiral computed  Diagnosis  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:李飞鹏,李明,华群,赵刘军,罗建宁.螺旋CT重建技术在骨盆环骨折中的诊治价值[J].中国骨伤,2010,23(3):204~207
英文格式:LI Fei-peng,LI Ming,HUA Qun,ZHAO Liu-jun,LUO Jian-ning.Study on the spiral CT reconstruction in the diagnosis and treatment of pelvic ring fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):204~207
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