急性颈椎外伤的CT诊断与评价

目的分析急性颈椎外伤（ａｃｕｔｅｃｅｒｖｉｃａｌｔｒａｕｍａ，ＡＣＴ）的ＣＴ表现，评价ＣＴ在ＡＣＴ诊断中的价值及限度。方法对临床拟诊的ＡＣＴ３７例行平片及薄层ＣＴ或高分辨率ＣＴ（ＨＲＣＴ）检查，并做多平面及三维（３Ｄ）重建。４例同时行ＭＲＩ检查。结果经影像学诊断３１例ＡＣＴ，其中ＣＴ诊断２９例，２例ＣＴ阴性而由平片及ＭＲＩ各确诊１例。平片与ＣＴ的骨折检出率分别为３２．８％及９８．５％，两者有极显著性差异。结论ＣＴ能对ＡＣＴ做出较全面而准确的诊断，与平片比较ＣＴ明显提高了骨折的检出率。在ＡＣＴ的诊断中，ＣＴ尚有某些限度。

CT diagnosis and evaluation of acute cervical trauma

Purpose To analyze CT findings of acute cervical trauma (ACT) and evaluate the value and limitation of CT in the diagnosis of ACT. Methods 37 cases highly suspected of ACT were studied with plain film and thin slice CT or HRCT. Multiplanner and 3D reformations were performed routinely. 4 cases were also examined with MR. Results 31 ACT were diagnosed. CT confirmed 29 cases. 1 case was demonstrated by plain film and MRI respectively, while missed by CT. Fracture detection rates of CT and plain film were 98.5% and 32.8% respectively, the difference was statistically significant. Conclusion CT is becoming an indispensable tool in the evaluation of ACT. Compared with plain film, CT markedly increases the fracture detection rate, although with some limitation.