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目的多层螺旋CT的MPR(mulitiplane reconstruction,MPR)在胫骨平台骨的诊断及分型中的应用价值。方法经X线平片或临床检查怀疑或确诊胫骨平台骨折的25例,对其中20例患者21侧胫骨平台行4层螺旋CT扫描并行MPR重组观察,由2组放射科医师分别对不同重建层厚及三维重组图像进行分析,在Schatzker分型的基础上,根据临床外科治疗的需要,对胫骨平台骨折进行CT三维分析。结果(1)2组医师应用1.25mm层厚共显示骨折线30条;1.25、5.0mm层厚图像骨折线显示率分别为96.6%、54.1%。(2)轴位薄层骨折线检查率96.6%。,MPR骨折线检出率100%,(3)21侧胫骨平台骨折SchatzkerⅠ型:劈裂骨折3例;Ⅱ型:塌陷骨折5例;Ⅲ型:劈裂+塌陷骨折10例;Ⅳ型:涉及胫骨髁嵴的平台骨折1例;Ⅴ型:内侧外侧平台双骨折1例;Ⅵ型:胫骨平台和上1/3联合骨折1例。结论多层螺旋CT的MPR在胫骨平台骨折的诊断、分型具有重要价值,MPR对手术治疗计划的制订和预后评价有重要的参考价值。
Objective To evaluate the value of mulitiplane reconstruction (MPR) in the diagnosis and classification of tibial plateau by multi-slice spiral CT. Methods Twenty-five cases of tibial plateau fractures suspected or confirmed by X-ray plain film or clinical examination were examined by 4-slice spiral CT scans of 20 patients on tibial plateau. MPR was performed by two radiologists on different reconstruction layers Thick and three-dimensional reconstruction images were analyzed. Based on the Schatzker classification, according to the needs of clinical surgical treatment, three-dimensional CT analysis of tibial plateau fractures was performed. Results (1) The two groups of doctors used 1.25mm layer thickness to display 30 fracture lines. The fracture line rates of 1.25mm and 5.0mm layer thickness images were 96.6% and 54.1% respectively. (2) Axial thin-layer fracture line examination rate of 96.6%. , MPR fracture line detection rate of 100%, (3) 21 side of the tibial plateau fracture Schatzker type Ⅰ: splitting fracture in 3 cases; type Ⅱ: collapse fracture in 5 cases; Ⅲ type: splitting + collapse fracture in 10 cases; type Ⅳ: 1 case of plateau fracture of tibial condylar ridge; Ⅴ type: 1 case of double fracture of medial lateral plateau; Ⅵ type: 1 case of tibial plateau and 1/3 joint fracture. Conclusion MPR in MSCT is of great value in the diagnosis and classification of tibial plateau fractures. MPR has important reference value for the planning and prognosis evaluation of surgical treatment plans.