摘要
目的 比较多层螺旋CT(multi-slice computed tomography,MSCT)三维重组与轴位骨窗诊断颅骨骨折的价值。资料与方法 2009年5月至10月本院连续性颅脑外伤病例500例,颅脑CT扫描资料薄层重组后行容积再现(volume rendering,VR)、最大密度投影(maximum intensity projection,MIP)重组,盲法评估轴位骨窗、VR及MIP三维重组图像检出骨折的情况。结果 轴位骨窗、VR、MIP平均检出骨折例数分别为53例(10.60%,53/500),73例(14.60%,73/500),87例(17.40%,87/500),其中粉碎性骨折10例(2.00%,10/500),三种方法均可检出,三者检出骨折条数分别为86、139、210条(粉碎性骨折除外,不计其数量),无论是例数还是条数,轴位骨窗与MIP有统计学差异(P<0.05),而VR与MIP无统计学差异(P>0.05)。与MIP相比轴位骨窗漏诊骨折34例(39.08%,34/87),124条(59.05%,124/210)。MIP检出颅缝分离21例(4.2%,21/500),轴位骨窗检出2例,VR检出1例。结论 MSCT扫描MIP重组对颅骨骨折检出率高,轴位骨窗对颅骨骨折漏诊率高,VR重组显示颅骨解剖结构有优势,MSCT三维重组可作为颅骨骨折诊断的常规技术。
Objective To find the value of three-dimensional reconstruction in detecting skull fractures compared with axial bone window images.Materials and Methods The MSCT images of 500 patients with previous head trauma were analyzed.All the raw data of skull were reconstructed by volume render（VR）and maximum intensity projection（MIP）.The detection of skull fractures were blindly evaluated by VR,MIP as well as axial bone window Images.Results There were 53（10.60%,53/500）,73（14.60%,73/500）,87（17.40%,87/500）cases of fractures were founded on axial bone window,VR and MIP images respectively.Ten cases of comminuted fractures were detected by three methods independently.Excluding the cases of comminuted fractures,the fracture lines detected on axial bone window,VR and MIP were 86,139,210 respectively.The There was significantly difference of detection rate between MIP with axial bone window（P0.05）,while there was no significantly difference between MIP with VR（P0.05）.There were 34（39.08%,34/87）cases and 124（59.05%,124/210）fracture lines missed on axial bone window.additionally,there were 2,1 and 21 cases of dissociated cranial sutures were founded on axial bone window,VR and MIP respectively.Conclusion MIP images depict skull fractures with high accuracy.Because VR has advantages in displaying 3D anatomical structures,we recommend MIP in addition to necessary VR as a conventional techniques to improve skull fractures detection.
出处
《临床放射学杂志》
CSCD
北大核心
2010年第11期1465-1468,共4页
Journal of Clinical Radiology
关键词
颅骨骨折
多层螺旋CT
三维重组
最大密度投影
容积再现
Skull fracture Multi-slice computed tomography Three-dimensional reconstruction Maximum intensity projection Volume rendering
