中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (52): 9841-9844.doi: 10.3969/j.issn.1673-8225.2010.52.038

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

螺旋CT三维重建在膝关节骨折中的应用　

王铁才　   

  1. 沈阳市红十字会医院放射科，辽宁省沈阳市     110013
  • 出版日期:2010-12-24 发布日期:2010-12-24
  • 作者简介:王铁才，副主任医师。 liuliu-85@163.com

Application of spiral CT three-dimensional reconstruction in knee joint fracture

Wang Tie-cai 　   

  1. Department of Radiology, Shenyang Red-cross Hospital, Shenyang  110013, Liaoning Province, China
  • Online:2010-12-24 Published:2010-12-24
  • About author:Wang Tie-cai, Associate chief physician, Department of Radiology, Shenyang Red-cross Hospital, Shenyang 110013, Liaoning Province, China liuliu-85@163.com

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摘要：

目的：探讨多层螺旋CT三维重建及后处理在膝关节骨折中的应用价值。
方法：由作者应用计算机检索PubMed数据库(http://www.ncbi.nim.nih.gov/PubMed)及CNKI数据库(www.cnki.net/index.htm) 1995/2009有关螺旋CT三维重建修复膝关节骨折的文献，检索关键词为“膝关节骨折，三维重建，CT断层扫描”，限定语言种类为英文和中文。排除重复、较陈旧的文献以及综述、Mete分析类文献。共28篇文献符合标准，中文14篇，英文14篇。同时结合病例进行分析，50例膝关节骨折患者均接受了普通X射线平片检查，经多层螺旋CT扫描和后处理，比较三种方案的检查结果，并与术中及术后观察结果进行对照。
结果：螺旋CT三维重建及后处理功能在膝关节骨折的诊断和治疗中具有重要的临床应用价值，可利用多平面重建、表面遮盖、容积再现和最大密度投影对轴位像进行补充。病例分析结果显示，X射线确诊率为88%，多层螺旋CT确诊率为100%，通过螺旋CT三维重建能够明确诊断，更正分型。
结论：多层螺旋CT三维重建能更准确地显示普通X射线平片所不能直接显示的关节面骨折，在显示关节腔及关节面骨折、明确骨折分型和膝关节损伤情况方面要优于普通X射线平片检查。

关键词: 膝关节骨折, 三维重建, 多层螺旋CT, 断层扫描, X射线

Abstract:

OBJECTIVE: To explore the application value of multi-slice spiral CT three-dimensional reconstruction and posttreatment in knee joint fracture.
METHODS: A computer-based online search of PubMed database (http://www.ncbi.nim.nih.gov/PubMed) and CNKI database (www.cnki.net/index.htm) was performed for related articles published between 1995 and 2009, with key words “knee joint fracture, three-dimensional reconstruction, CT scan” in English and Chinese. Repetitive and outdated articles, review articles and Meta analysis were excluded. A total of 28 articles, including 14 Chinese and 14 English, were selected. A total of 50 patients with knee joint fracture underwent X-ray examination, multi-slice spiral CT scanning and posttreatment. Results of the three methods were compared in addition to comparison with intraoperative and postoperative observations.
RESULTS: Multi-slice spiral CT three-dimensional reconstruction and posttreatment exhibit significant clinical values in the diagnosis and treatment of knee joint fracture. Multi-plane reconstruction, surface shielding, volume rendering and maximum intensity projection can be used to enhance axial images. Case analysis showed that the diagnosis rate was 88% by X-ray, 100% by multi-slice spiral CT. So multi-slice spiral CT three-dimensional reconstruction can confirm diagnosis and correct typing.
CONCLUSION: Multi-slice spiral CT three-dimensional reconstruction can accurately display articular surface fracture that cannot be displayed on common X-ray films, and exhibit superior role in displaying articular cavity and articular surface fractures, identifying fracture type and joint injury over X-ray examination.

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