【摘要】 目的探讨MSCT重建在诊断四肢关节隐匿性骨折的应用价值。方法回顾分析2010年2月~2014年4月四肢骨关节外伤后行X线片、CT常规轴位平扫显示可疑或阴性,而行MSCT三维重建发现或确诊四肢关节隐匿性骨折的27例患者临床资料。结果 27例骨关节外伤后行X线片、CT常规轴位平扫显示阴性或可疑骨折患者中,25例MSCT重建明确诊断骨折,1例MSCT重建未发现骨折而MRI诊断骨折;1例MSCT重建诊断骨折而MRI证实无骨折;MSCT重建诊断骨折符合率达92.6%。本组股骨颈线状不完全性骨折10例,胫骨平台轻微塌陷骨折6例,腕骨骨折7例,足跗骨中中间楔骨3例。结论 MSCT重建特别是多平面重建(MPR)及容积再现(VR)在骨关节隐匿性骨折诊断中具有明显优势。在骨关节外伤患者中如X线片阴性,临床进一步检查时应首选MSCT重建扫描以明确诊断,而不是简单的行CT常规轴位扫描。更多还原

【Abstract】 Objective To study the value of multi-slice spiral computed tomography( MSCT) reconstruction in the diagnosis of extremities occult fractures. Methods A total of 27 arthrotrauma cases admitted from February 2010 to April 2014 were analyzed retrospective. All cases were showed suspicious or negatives by X-ray and CT with normal axial scan,but found or diagnosed occult fractures in extremities by MSCT three-dimensional reconstruction. Results In all 27 patients,25 cases with occult fractures were diagnosed definitely by MSCT reconstruction and the coincidence rate of diagnosis was 92. 6%. One case was not found fracture by MSCT reconstruction but showed fracture by MRI exam,another case was diagnosed fracture by MSCT but confirmed no fracture by MRI. All of them,there was incomplete femur neck fracture in 10 cases,light tibial plateau collapse fracture in 6 cases,carpal fracture in 7 cases and intermediate cuneiform bone of tarsal bone in3 cases. Conclusions MSCT reconstruction especially multiplanar reconstruction( MPR) or volume rendering( VR) has distinct advantages in the diagnosis of occult fracture of bone and joint. For the bone and joint trauma patients with negative result of x-ray,row MSCT reconstruction is the preferred choice to definitive diagnosis,instead of rather than simply lines of conventional axial CT scan.更多还原