CAJ | 학술논문

目的：探讨64排螺旋CT及工作站重建功能在颅骨骨折中的诊断价值。方法收集我院颅脑外伤住院患者77例，全部患者行常规64排螺旋CT扫描，根据外伤的部位选用相应软件进行三维重建，检查结果进行分析、统计。结果颅骨骨折频发部位依次为：鼻骨19例，颧骨16例，上、下颌骨15例，眼眶骨和颞骨鳞部各13例，额骨11例，颞骨乳突部8例，顶骨7例，枕骨6例，颅底骨折6例。其中28例患者合并多发颅骨骨折。VR重建像对显示骨折整体形态较好，可清楚显示骨折线与硬脑膜中动脉和静脉窦的关系；Surface MIP重建像对显示骨折线的延伸范围和对分离性骨缝骨折效果较好，尤其对微细骨折显示良好；约20%骨折患者引发了颅内延时出血；合理联合应用多种重建软件可提高对颅骨骨折诊断准确率。结论颅骨骨折有频发部位，合理利用64排螺旋CT及工作站后处理功能，可提高对颅骨骨折诊断正确率，通过显示骨折线的走行及与颅内重要结构的解剖关系，可为临床医师设计皮瓣、骨瓣，选择手术时机，选择手术部位及评估手术风险和预后提供重要参考信息。
목적：탐토64배라선CT급공작참중건공능재로골골절중적진단개치。방법수집아원로뇌외상주원환자77례，전부환자행상규64배라선CT소묘，근거외상적부위선용상응연건진행삼유중건，검사결과진행분석、통계。결과로골골절빈발부위의차위：비골19례，권골16례，상、하합골15례，안광골화섭골린부각13례，액골11례，섭골유돌부8례，정골7례，침골6례，로저골절6례。기중28례환자합병다발로골골절。VR중건상대현시골절정체형태교호，가청초현시골절선여경뇌막중동맥화정맥두적관계；Surface MIP중건상대현시골절선적연신범위화대분리성골봉골절효과교호，우기대미세골절현시량호；약20%골절환자인발료로내연시출혈；합리연합응용다충중건연건가제고대로골골절진단준학솔。결론로골골절유빈발부위，합리이용64배라선CT급공작참후처리공능，가제고대로골골절진단정학솔，통과현시골절선적주행급여로내중요결구적해부관계，가위림상의사설계피판、골판，선택수술시궤，선택수술부위급평고수술풍험화예후제공중요삼고신식。
Objective To investigate the value of 64-slice spiral CT and workstation reconstruction functions in the diagnosis of skull fracture. Methods Seventy-seven patients with craniocerebral injury were enrolled and underwent 64-slice spiral CT. According to the injury site, the corresponding software of 3D reconstruction was used. The examina-tion results were statistically analyzed. Results Skull fracture was prone to occur in:nasal bone (19 cases), cheekbones (16 cases), the upper and lower jaw (15 cases), orbital bone (13 cases) and squamous bone (13 cases), frontal bone (11 cas-es), temporal bone mastoid (8 cases), parietal bone (7 cases), occipital bone (6 cases), and basion (6 cases). 28 cases were found with multiple skull fractures. The VR reconstruction of fractures showed better overall shape, which can clearly show the relationship between fracture line and venous sinus, middle arterial of the dura mater. Surface MIP reconstruction showed good performance in displaying the extended scope of fracture line and dissociative bone fracture. About 20%of the patients were found with delayed intracranial hemorrhage. Combined application of various reconstruction softwares can improve the diagnostic accuracy of skull fracture. Conclusion The rational utilization of 64-slice spiral CT and work-station function can improve the diagnostic accuracy of skull fracture, and provides reference for the design of flap, the se-lection of the timing of surgery, surgical site, as well as the assessment of risks and prognosis.