64排螺旋CT对胫骨平台隐匿性骨折的诊断及临床意义

目的:探讨64排螺旋CT对胫骨平台隐匿性骨折的诊断价值及临床意义。方法:收集2008年1月至2011年12月连续21例门急诊下肢外伤后普通X线平片表现为阴性及可疑骨折,64排螺旋CT检查确诊为胫骨平台骨折患者影像资料,并重新采用多层面重建(MPR);容积显示(VR)和最大灰度重建(MIP)等多种后处理技术进行回顾性分析。结果:MDCT3D共显示SchatzkerⅠ型10例;Ⅱd型4例;Ⅲ3例;Ⅳ型2例;Ⅳ型1例和Ⅴ型1例。结论:64排螺旋CT联合应用多种重建技术对胫骨平台隐匿性骨折的评价是可靠和准确的。可以准确评估21例胫骨平台骨折的部位、类型、程度及并发症等。明显提高了诊断准确性,避免了普通平片对胫骨平台隐匿性骨折的漏诊及误诊。可为临床采取及时有效的治疗提供更准确、更丰富的诊断信息。

Application of 64 Multi-detector Helical CT in Evaluation of the Tibial Plateau Occult Fracture

Objective： To evaluate the diagnostic value of 64 multi-detector helical CT of the tibial plateau occult fracture. Methods： MDCT scans were performed in 21 patients who were suspected fracture of tibial plateau but negative （12 cases） or probable positive （9 cases） on X-ray film （including CR and DR）. The data＇s was transmitted to ADW4.3 workstation, and reconstructed by MPR, MIP, VR and generally analyzed with original axial images. Results： MDCT 3D demonstrated Schatzker type I 10 cases; type II 4 cases; type III 3 cases; IV 2 cases; type IV 1 case and type V 1 case. Conclusion： 21 cases fracture of tibial plateau were demonstrated clearly by 64-MDCT, and it can reveal the location, types, level and complication of fracture change, it is reliable and accurate in evaluating occult fracture of tibial plateau, gradually become necessary modality examination in patients after trauma of knee joint and therefore should be applied to clinically suspicious cases.