【摘要】 目的评价螺旋CT检查对头颈部创伤患者的诊断价值。方法回顾性分析临床和手术证实的36例因严重头颈部急性创伤而行头颈部CT检查患者的影像学表现,并与常规X线平片进行比较。结果36例患者共有78处颈椎损伤。其中2例枕骨髁、1例第一颈椎前弓和后弓、1例第一颈椎左侧侧块、1例椎弓根、15例椎板及2例横突骨折,X线平片均未能正确作出诊断,而CT均作出正确诊断。只有1例韧带损伤颈椎旋转、不稳患者,X线平片发现异常而CT未能诊断。螺旋CT与X线平片对颈椎损伤诊断的灵敏度分别为98.7%和57.6%,两者的差别非常显著(χ2=38.5,P<0.005)。结论螺旋CT较X线平片能更多、更早地发现颈椎骨折,可列为头颈部创伤患者的常规检查。更多还原

【Abstract】 Objective To evaluate role of helical CT in diagnosing trauma in head and neck. Methods 36 patients with acute severe trauma in head and/or neck underwent CT scan. Their situations were confirmed by clinical data and surgery. Data of CT scan were retrospectively analyzed in comparison with X-ray findings. Results There were 78 fractures and dislocations in cervical vertebrae of the 36 patients. 2 patients had lesions in occipital condyle, 1 patient in anterior arch and posterior arch of first cervical vertebrae, 1 patient in left lateral mass of first cervical vertebrae, 1 in vertebral pedicle, 15 in vertebral lamina and 2 in transverse process. All fractures and dislocations were correctly diagnosed by CT but X-ray plain scan failed. However, one patient who had rotated and unstable cervical vertebrae due to impaired ligament was detected by X-ray plain scan while CT failed. Sensitivity of helical CT and X-ray plain scan for detecting trauma in cervical vertebrae was 98.7% and 57.6% respectively, the difference was significant (χ2= 38.5,P < 0.005). Conclusion Helical CT can detect fractures in head and neck earlier and better than X-ray plain scan, deserving a routine examination in case of need.更多还原