16层螺旋CT及其三维重建与多平面重组在胫骨平台骨折诊断中的应用

目的探讨16层螺旋CT(16层SCT)及其三维重建(3-D)与多平面重组(MPR)在胫骨平台骨折诊断中的应用价值。方法39例胫骨平台骨折病例经膝关节常规X线平片检查后，采用16层SCT进行膝关节的多层面螺旋CT扫描，在工作站上作3D及MPR影像后处理，就胫骨平台骨折的平片与16层SCT影像进行比较及综合分析。结果39例胫骨平台骨折中，X线平片漏诊1例髁间隆突骨折、1例内髁骨折及1例双髁骨折，此3例(7．69％)平片漏诊的骨折均为16层SCT予以诊断。16层SCT的3-D影像可清晰显示胫骨平台骨折的立体形态；MPR影像则可明确显示胫骨平台内部的骨质损伤情况如骨折的具体部位、关节面碎裂及塌陷程度、骨折移位距离。结论16层SCT能够显示X线平片难于诊断的胫骨平台隐匿性骨折；3-D及MPR成像技术十分有利于全面观察胫骨平台骨折的形态变化，是16层SCT横轴位扫描的重要补充。

Application of 16 slice spiral CT with its 3 - D reconstruction and multiplanar reformation in the diagnosis of tibial plateau fractures

Objective To evaluate diagnostic value of 16 slice spiral CT(16 slice SCT)with its 3-dimensional reconstruction(3-D)and multiplanar reformation(MPR)in assessment of tibial plateau fracture(TPF). Methods After conventional X-ray plain films of knee joints were performed, 39 patients of TPFs were examined with axial scanning of 16 slice SCT. 3-D and MPR was acquired with reforming axial imaging of 16 slice SCT on workstation. Comparison and comprehensive analyses of imaging appearances of TPFs were performed between X-ray plain and 16 slice SCT. Results Among 39 cases of TPFs, 1 case of intercondylar eminence fracture, 1 case of internal condyle fracture and 1 case of bilateral condyle fracture were respectively missing on plain film. The 3 case(7.69 %)of TPFs were obviously demonstrated by 16 slice SCT. 3-D of 16 slice SCT could distinctly demonstrate stereoscopic shape of TPFs. MPR of 16 slice SCT could accurately demonstrate internal morphological changes of bone lesion in tibial plateau such as location of fracture, disruption and collapse of articular surface, distance of fracture dislocation. Conclusion 16 slice SCT can effectively reveal the occult fractures of tibial plateau, those were not visible on X-ray plain film. 3-D and MPR are very beneficial to entirely observing the morphological changes of TPF, and are important supplements for axial scanning of 16 slice SCT.