CAJ | 학술논문

目的：分析髋臼骨折CT及三维重建表现，探讨其临床应用价值。材料与方法：50例髋臼骨折均摄X线平片及CT横断扫描，其中45例采用SSD(表现遮盖法)或MPR(多平面重建)技术作三维重建。分析50例髋臼骨折的横断及三维重建CT表现，根据Letournel分型将其分类，重点探讨三维重建的应用价值。结果：50例髋臼骨折中，①简单骨折22例，其中前壁骨折5例，前柱骨折3例，后壁骨折6例，后柱骨折4例，横行骨折4例，X线平片仅显示19例骨折。②复杂骨折28例，其中双柱骨折9例，T型骨折4例，后柱伴后壁骨折6例，前柱伴后半横行骨折4例，横行伴后壁骨折5例。CT横断扫描共显示关节腔内骨折碎片54块，X线平片仅显示关节腔内骨折碎片32块，并清楚显示软组织损伤情况。三维重建图像多角度、立体显示骨折及移位情况。50例髋臼骨折中，38例行手术治疗，12例保守治疗。手术中所见与CT扫描结果完全一致。结论：髋臼骨折CT扫描能准确对骨折分型，三维重建可弥补横断影像的不足，有助于骨折的立体定位，对治疗方案的选择及预后提供客观依据。
목적：분석관구골절CT급삼유중건표현，탐토기림상응용개치。재료여방법：50례관구골절균섭X선평편급CT횡단소묘，기중45례채용SSD(표현차개법)혹MPR(다평면중건)기술작삼유중건。분석50례관구골절적횡단급삼유중건CT표현，근거Letournel분형장기분류，중점탐토삼유중건적응용개치。결과：50례관구골절중，①간단골절22례，기중전벽골절5례，전주골절3례，후벽골절6례，후주골절4례，횡행골절4례，X선평편부현시19례골절。②복잡골절28례，기중쌍주골절9례，T형골절4례，후주반후벽골절6례，전주반후반횡행골절4례，횡행반후벽골절5례。CT횡단소묘공현시관절강내골절쇄편54괴，X선평편부현시관절강내골절쇄편32괴，병청초현시연조직손상정황。삼유중건도상다각도、입체현시골절급이위정황。50례관구골절중，38례행수술치료，12례보수치료。수술중소견여CT소묘결과완전일치。결론：관구골절CT소묘능준학대골절분형，삼유중건가미보횡단영상적불족，유조우골절적입체정위，대치료방안적선택급예후제공객관의거。
Objective: To evaluate CT and three - dimensional(3D) CT imagingreconstruction findings of acetabular fractures and study its clinical applications. Materials and Methods:To study CT and 3D CT findings of 50 cases acetabular fractures, X - ray plain film and CT was done at 50 cases of acetabular fractures. 3D imaging Reconstruction was done at 45 cases acetabular fractures with SSD(Shaded Surface Display)or MPR(Multiplanar Reconstruction)methods. CT and 3D CT finding analysis was done according to letournel classification. Clinical applications of 3D CT imaging Reconstruction was studied emphasize. Results: The results showed that there were ① 22 cases simple fractures, includes: 5 cases of the anterior wall, 3 cases of the anterior column, 6 cases the posterior wall,4 cases of the posterior column, 4 cases of the transverse. X - ray plain film showed only 19 cases. ② 28 cases complex fractures, includes: 9 cases the double column, 4 cases the T - shaped, 6 cases of the posterior column and posterior wall,4 cases of the anterior column and a hemi - transverse fractures line posteriorly, 5 cases of the transverse and posterior wall. CT scans show the osseous fragment in joint that could not be detected at plain film. The soft - tissue damage was also revealed. 3D imaging Reconstruction show the fractures from multiangular and three - dimensional. Surgical operation was performed in 38 cases acetabular fractures, and the CT results was same as the surgical operation in 38 cases. 12 patients were treated nonoperatively. Conclusion: Acetabular fractures can be correctly classify with CT scans. Shortage of sequence imaging can be supply by 3D CT Reconstruction and provide evidence on choosing therapeutic methods and evaluating prognosis.