目的　探讨眼眶爆裂骨折的螺旋CT(SCT)表现 ,评价临床指导价值。方法　 12 0例眼眶爆裂骨折行SCT容积扫描得到常规轴位像后 ,通过重建得到多平面 (MPR)图像 ,根据图像分析并结合临床征象 ,其中 10 8例保守治疗 ,12例手术治疗。结果　眼眶爆裂骨折的直接CT征象为眶壁骨质连续性中断、粉碎、凹陷及曲度失常 ,上颌窦腔出现“泪滴征”是诊断眼眶下壁骨折的特异性间接征象 ,眼外肌明显嵌顿及眼球内陷和牵位试验阳性是手术治疗的指征。结论　SCT容积扫描多平面像能全面、准确地诊断眼眶爆裂骨折 ,对临床治疗方法的选择有重要价值 Objective To investigate the spiral CT (orbital CT) manifestations of orbital blowout fractures and evaluate the value of clinical guidance. Methods 120 cases of orbital blowout fracture were scanned by SCT volume scan to get the MPR images. According to the image analysis and clinical signs, 108 cases were conservative treatment and 12 cases were operated on. Results The direct CT signs of orbital blowout fracture were discontinuous orbital bone continuity, comminuted sag and curvature. The “tear drop sign” in the maxillary sinus cavity was a specific indirect sign to diagnose the inferior orbital wall fracture. The extraocular muscle was obvious Incarceration and eye retraction and traction test positive is an indication of surgical treatment. Conclusion SCT volume scanning multiplanar imaging can diagnose orbital blowout fracture comprehensively and accurately, which is of great value to the choice of clinical treatment