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目的 :探讨螺旋CT三维影像 (SSD和MPR)在骨关节创伤中的应用价值及相关的技术要点。方法 :研究经X线和螺旋CT证实的骨关节创伤病例 85例。扫描参数 :① 3mm层厚、4.5mm床速和 1～ 2mm重建间距 ;② 5mm层厚、5～7.5mm床速和 2mm重建间距 ;作SSD时阈值范围之低值为 12 0～ 180 ,观察SSD和MPR的窗宽和窗位分别为 3 0 0 0～ 3 2 0 0、10 0 0～ 12 0 0和 80 0～ 10 0 0、2 5 0～ 3 0 0。结果 :横断面结合SSD和MPR像显示骨折 83例 ,脱位或半脱位 19例。 85例SSD像 ,图像质量优秀 5 6例 ,良好 19例 ,较差 10例 ,SSD像立体地显示了骨折线的长短、形态、走向 ,碎骨片的形态、大小、空间位置以及骨折的移位和关节对位状况 ;68例跨关节MPR像 ,图像质量优秀 45例 ,良好 14例 ,较差 9例 ,MPR像更清晰地显示关节的受累和关节腔内游离骨片。结论 :螺旋CT的SSD和MPR像能提供骨关节创伤非常有价值的空间关系信息 ,其表现接近病理解剖 ,临床应用价值大 ,利于临床医师选择治疗方案和制订手术计划
Objective: To investigate the value of spiral CT three-dimensional imaging (SSD and MPR) in the treatment of bone and joint trauma and related technical points. Methods: 85 cases of bone and joint injuries confirmed by X-ray and spiral CT were studied. Scanning parameters: ① 3mm layer thickness, 4.5mm bed speed and 1 ~ 2mm reconstruction interval; ② 5mm layer thickness, 5 ~ 7.5mm bed speed and 2mm reconstruction spacing; for the SSD when the threshold value of the low value of 12 0 ~ 180, observed The window width and the window level of the SSD and MPR are respectively from 3000 to 30000, from 10 0 to 12 0 0 and from 80 0 to 10 0 0, 25 0 to 30 0. Results: The cross-sectional images of SSD and MPR showed 83 cases of fracture, 19 cases of dislocation or subluxation. 85 cases of SSD images, excellent image quality in 56 cases, good in 19 cases, poor in 10 cases, SSD like three-dimensional display of the length of the fracture line, shape, orientation, bone fragments morphology, size, spatial location and fracture shift Position and joint alignment status; 68 cases of cross-joint MPR images, excellent image quality in 45 cases, good in 14 cases, poor in 9 cases, MPR images more clearly show the joint involvement and free intra-articular bone fragments. Conclusion: The SSD and MPR images of spiral CT can provide very valuable spatial relationship information of osteoarticular trauma. Its performance is close to the pathological anatomy and has great value in clinical application, which helps clinicians choose the treatment plan and formulate the operation plan