CAJ | 학술논문

目的:探讨16层螺旋CT对外伤性筛骨骨折的诊断价值.方法:收集经常规轴位颅底5mm螺旋扫描2.5mm高分辨率骨算法重建(常规组),复查时接受2.5mm薄层螺旋扫描1.25mm高分辨率骨算法重建(薄层组),共108例,比较这两种扫描方法的骨折诊断情况.结果:108例筛骨骨折患者中,骨折线仪累及筛骨右侧40例,仅累及左侧47例,累及双侧21例;线性骨折37侧,凹陷性骨折71侧;筛骨骨折伴内直肌肿胀、迂曲46侧,筛窦眶内容物疝57侧,内直肌与纸样板间脂肪间隙变窄或消失85侧.脂肪间隙增宽9侧,脂肪间隙混浊98侧;眶内积气29侧,眼球内陷12侧,眼球突出18侧,伴视神经肿胀23侧,筛窦外伤性积液、积血59侧.比较两组骨折显示率:常规组为78.20%;薄层组为100%,经统计学(U检验)分析差异有高度显著性(P<0.01).结论:常规组扫描法能显示筛骨骨折的直接征象和间接征象,能很好地分型,有诊断价值;缺点是漏诊率较高.薄层组扫描法对筛骨骨折的正确分型以及显示骨折的直接和间接征象的能力都明显地优于常规组,能克服常规组的不足.能充分发挥16层螺旋CT的优势,对法医伤情鉴定及临床治疗具有重要意义,值得推广.
목적:탐토16층라선CT대외상성사골골절적진단개치.방법:수집경상규축위로저5mm라선소묘2.5mm고분변솔골산법중건(상규조),복사시접수2.5mm박층라선소묘1.25mm고분변솔골산법중건(박층조),공108례,비교저량충소묘방법적골절진단정황.결과:108례사골골절환자중,골절선의루급사골우측40례,부루급좌측47례,루급쌍측21례;선성골절37측,요함성골절71측;사골골절반내직기종창、우곡46측,사두광내용물산57측,내직기여지양판간지방간극변착혹소실85측.지방간극증관9측,지방간극혼탁98측;광내적기29측,안구내함12측,안구돌출18측,반시신경종창23측,사두외상성적액、적혈59측.비교량조골절현시솔:상규조위78.20%;박층조위100%,경통계학(U검험)분석차이유고도현저성(P<0.01).결론:상규조소묘법능현시사골골절적직접정상화간접정상,능흔호지분형,유진단개치;결점시루진솔교고.박층조소묘법대사골골절적정학분형이급현시골절적직접화간접정상적능력도명현지우우상규조,능극복상규조적불족.능충분발휘16층라선CT적우세,대법의상정감정급림상치료구유중요의의,치득추엄.
Purpose:To evaluate the value of 16- MSCT in diagnosis of ethmoid fracture. Methods: CT features of 108 cases of patients with ethmoid fractures were evaluated and analyzed. Conventional 5 mm thin-section helical CT scanning with 2.5 mm bone algorithm reconstruction method(conventional method) was used for the first exam, and 2.5 mm thin-section helical CT scanning with 1.25 mm bone algorithm reconstruction method (thin-section method) was used for the follow-up exam. The results with conventional method and thin-section method were compared. Results: In 108 cases, there were 40 cases of ethmoid fractures in right side, 47 in left, 21 in bilateral. There were 37 sides of linear fractures and 71 sides of depressed fractures. The rates of fracture detection in 108 cases that were scanned by two methods were calculated and analyzed with U-test. And the results showed a marked different between these two methods (P< 0.01). Conclusion: Conventional method can reveal the direct and indirect features of ethmoid fractures, it is valuable in diagnosis of traumatic ethmoid fractures, but it has higher miss diagnosis rate. Thin-section method can improve the detection rate of ethmoid micro -fractures, and it is valuable in identification of traumatic degree, and is useful for legal medical identification and clinical treatment.