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目的 :探讨获得高质量颞颌关节三维CT影像的方法 ,评价其对髁突骨折的诊断价值。方法 :对 14例髁突骨折患者 ,采用 3种扫描方式 (横断、冠状、螺旋 ) ,2种扫描范围 (横断位 :眶耳平面上方 1cm至下颌升支中份或颏下点。冠状位 :乳突至下颌升支前缘或颏前点。)和 2种层厚 (2 5mm、5 0mm)扫描 ,以勾画法删除层面影像中的颈椎、茎突、枕骨和部分乳突 ,表面阴影显示法 (SSD)完成三维重建。结果 :2 5mm薄层横断扫描获得的三维重建影像质量最佳 ,勾画删除技术的应用有利于消除颈椎等对骨折观察的影响。 14例患者检出髁突骨折 2 1侧 ,骨折部位、髁突移位情况显示理想。结论 :薄层横断扫描配合勾画删除技术 ,可获得高质量三维重建影像 ,准确、直观地显示髁突骨折情况。
Objective: To explore the method of obtaining high quality three dimensional CT images of temporomandibular joint and to evaluate the diagnostic value of condyle fractures. Methods: Fourteen patients with condylar fractures were examined by three scanning methods (transection, coronal and spiral), two scanning ranges (transverse position: 1 cm above the orbit ear plane, Mastoid to mandibular ascending anterior margin or chin point.) And two kinds of layer thickness (2 5mm, 50mm) scan, to delete the delineation of cervical vertebra, styloid process, occipital and some papillae, the surface shading Law (SSD) to complete the three-dimensional reconstruction. Results: The quality of three-dimensional reconstructed images obtained by 2 5mm thin slice transection was the best, and the application of delineation and deletion technique was helpful to eliminate the influence of cervical spine on fracture observation. Twenty-two cases of condylar fractures were detected in 14 cases, and the displacement of fractures and condyles showed satisfactory results. CONCLUSION: The thin slice transverse scan combined with the sketching and deletion technique can obtain high quality 3D reconstruction images and accurately and directly show the condylar fracture.