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目的:探讨CT平扫及三维重建对齿状突合并周围骨折的诊断价值。方法:回顾性分析在我院手术治疗的20例新鲜齿状突骨折合并周围骨折患者的X线片及CT平扫和三维重建资料。结果:20例患者术前影像学诊断齿状突合并周围骨折23处,术中另发现5例患者各有1处术前影像资料漏诊的周围骨折,合并存在的周围骨折共28处。其中单凭X线片确诊齿状突骨折5例,检出率25.0%(5/20),合并周围骨折2处,检出率7.1%(2/28);CT平扫及三维重建确诊齿状突骨折20例,检出率100%(20/20),发现23处周围骨折,检出率82.1%(23/28)。结论:CT平扫及三维重建对齿状突合并周围骨折能作出较全面而准确的诊断,与X线片相比明显提高了骨折的检出率。建议对怀疑有齿状突合并周围骨折的患者进行CT平扫及三维重建检查。
Objective: To investigate the value of CT plain scan and three-dimensional reconstruction in the diagnosis of odontoid process and peripheral fractures. Methods: The data of 20 cases of fresh odontoid fractures and peripheral fractures surgically treated in our hospital were retrospectively analyzed by X-ray, CT and 3D reconstruction. Results: Preoperative imaging diagnosis of 20 cases of odontoid combined with the surrounding fractures in 23 cases, another 5 patients were found in each of 5 patients had a preoperative imaging data missed peripheral fractures, the combined presence of a total of 28 peripheral fractures. Among them, 5 cases of odontoid fracture were diagnosed by X-ray alone, the detection rate was 25.0% (5/20), and 2 cases were complicated with peripheral fractures. The detection rate was 7.1% (2/28) Sudden process fractures in 20 cases, the detection rate was 100% (20/20), found 23 peripheral fractures, the detection rate was 82.1% (23/28). Conclusion: CT plain scan and three-dimensional reconstruction can make a more comprehensive and accurate diagnosis of odontoid process and peripheral fractures, and significantly improve the detection rate of fracture compared with X-ray film. It is recommended that patients with suspected odontoid fracture and peripheral CT scan and three-dimensional reconstruction of the examination.