多层螺旋CT在眼眶爆裂骨折诊断中的应用
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摘要
目的探讨多层螺旋CT(multi-detector row computed tomography,MDCT)及后处理技术在诊断眼眶爆裂骨折中的应用价值。方法收集162例眼眶爆裂骨折病例的多层螺旋CT横断位平扫图像,经薄层重建后行MPR多平面重组以及VR三维重建,部分行曲面重组,并对结果进行统计学分析。结果多层螺旋CT薄层及后处理技术对眼眶壁骨折、爆裂骨折间接征象及邻近并发骨折的显示优于CT平扫,薄层在对细微骨折的显示上有明显优势,MPR技术对眼眶壁骨折及间接征象的显示上优于平扫。结论多层螺旋CT薄层及后处理技术能有效减少使用CT诊断眼眶爆裂骨折时的错、漏诊情况,有效提高检出率。
Objective: To investigate the value of the thin layer and post-processing technique of MDCT(multi-detector row computed tomography) in diagnozing orbital blowout fractures. Methods:162 patients with orbital blowout fractures were collected. All of these cases were examined preoperatively under MDCT scans, MPR(multiple planar reformation) and VR(volume rendering) afterprocessing techniques of the orbit, and then CPR(curved planar reformation) technique was used for some cases.All the data were analyzed statistically. Results: Compared with the transaxial CT scan, the thin layer and post-processing technique of MDCT performed better when showing orbital wall fractures, indirect signs of blowout fractures and adjacent fractures. The thin layer technique had obvious advantage in displaying fine fractures, while MPR technique was superior to plain scan in displaying orbital wall fractures and indirect signs. Conclusion: The thin layer and afterprocessing techniques of MDCT can effectively reduce the number of the missed diagnoses for orbital blowout fractures and improve the detection rate.
Objective: To investigate the value of the thin layer and post-processing technique of MDCT(multi-detector row computed tomography) in diagnozing orbital blowout fractures. Methods:162 patients with orbital blowout fractures were collected. All of these cases were examined preoperatively under MDCT scans, MPR(multiple planar reformation) and VR(volume rendering) afterprocessing techniques of the orbit, and then CPR(curved planar reformation) technique was used for some cases.All the data were analyzed statistically. Results: Compared with the transaxial CT scan, the thin layer and post-processing technique of MDCT performed better when showing orbital wall fractures, indirect signs of blowout fractures and adjacent fractures. The thin layer technique had obvious advantage in displaying fine fractures, while MPR technique was superior to plain scan in displaying orbital wall fractures and indirect signs. Conclusion: The thin layer and afterprocessing techniques of MDCT can effectively reduce the number of the missed diagnoses for orbital blowout fractures and improve the detection rate.
引文
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[11] 夏亮,刘健华,范俊飞.眼眶爆裂骨折的多层螺旋CT表现分析[J].实用医学影像杂志,2016,17(6):519-521.
[12] Rosenthal E,Quint DJ,Johns M,et al.Diagnostic maxilla facial coronal images refor- matted from helical acquired thin section axial CT data[J].Am J Roentgen,2000,175(4):1177-1181.
[13] 张蕾,赵斌.64层CT容积再现对眼眶骨折的临床应用探讨[J].医学影像学杂志,2012,22(4):662-664.
[2] Fan B,Chen H,Sun YJ,et al.Clinical effects of 3-D printing-assisted personalized reconstructive surgery for blowout orbital fractures[J].Graefe's Archive for Clinical and Experimental Ophthalmology,2017,255(10):2051-2057.
[3] 张翔,陈伟,曹罡,等.计算机辅助快速成型钛网在眼眶爆裂骨折整复中的应用[J].医学研究生学报,2016,29(4):407-410.
[4] Amrith S,Almousa R,Wong WL,et al.Blowout fractures:surgical outcome in relation to age,time of intervention,and other preoperative risk factors[J].Craniomaxillofac Trauma Reconstr,2010,3(3):131-136.
[5] Jacobs SM,Sharifi E,Wu L,et al.Association between pre- and intraorbital soft tissue volumes and the risk of orbital blowout fractures using CT-based volumetric measurements[J].Orbit (Amsterdam,Netherlands),2018,20:1-5.
[6] Chi MJ,Ku M,Shin KH,et al.An Analysis of 733 Surgically Treated Blowout Fractures[J].Ophthalmologica,2010,224(3):167-175.
[7] Ahmad Nasir S,Ramli R.Predictors of enophthalmos among adult patients with pure orbital blowout fractures[J].PloS one,2018,13(10):e0204946.
[8] Erling BF,Iliff N,Robertson B.Footprints of the globe:A practical look at the mechanism of orbital fractures,with a revist to the work of Raymond Pfeiffer[J].Plast Reconstr Surg.1999,103(4);1313-1316.
[9] 夏顺明,张小胜,杨渭川.眼眶爆裂性骨折的螺旋CT诊断[J].中国中西医结合影像学杂志,2008,6(5):366-367.
[10] 尹智,杨振海,赵毅凯,等.眼眶爆裂性骨折的CT评估[J].眼外伤职业眼病杂志,2009,31(7):512-515.
[11] 夏亮,刘健华,范俊飞.眼眶爆裂骨折的多层螺旋CT表现分析[J].实用医学影像杂志,2016,17(6):519-521.
[12] Rosenthal E,Quint DJ,Johns M,et al.Diagnostic maxilla facial coronal images refor- matted from helical acquired thin section axial CT data[J].Am J Roentgen,2000,175(4):1177-1181.
[13] 张蕾,赵斌.64层CT容积再现对眼眶骨折的临床应用探讨[J].医学影像学杂志,2012,22(4):662-664.