【作者】 杨可乐；

【导师】 刘林祥； 丁小龙；

【作者基本信息】 泰山医学院 ， 影像医学与核医学， 2005， 硕士

【摘要】 目的：通过螺旋CT重建图像来探讨跟骨骨折的特征及其在跟骨骨折诊断中的临床应用价值。材料与方法：经CR或临床检查可疑或确诊有跟骨骨折的病人,应用LightSpeedPlus/i GE扫描机进行检查,其中对44例47侧跟骨关节内骨折行多平面及表面重建,对跟骨骨折进行分类,同时分析各关节面受累及骨折块数目显示等情况。结果：跟骨结节位扫描是显示各关节受累总数最多的一种方法(95/101),冠状位重建是显示距下中(14/14)、后(47/47)关节面受累的较佳方法,而跟骰关节的骨折则在跖位(32/32)、结节位(32/32)扫描时得到较准确的显示,矢状位重建在显示骨折块数目及排列方面有一定的优势；表面三维重建则是观察跟骨骨折整体空间改变的一种方法；47侧关节内骨折中,除了3侧载距突骨块发生轻度移位,其它无一发生移位；11(11/47)侧关节内骨折者,后关节面的压缩及旋转移位的情况在冠状位上并没有被准确的反映出来；螺旋CT可较清晰的显示周围软组织特别是腓骨肌腱的损伤。结论：螺旋CT重建在跟骨骨折诊断中具有很高的临床价值,对术前骨折的分型、手术入路的选择及估计预后有重要价值。更多还原

【Abstract】 Objective To investigate the characteristics of calcaneal fractures with spiral CT multiplanar volume reconstruction (MPVR)、surface shaded display (SSD), and to determine the value of MPVR and SSD in the diagnosis of calcaneal fractures.Materials and Methods Patients suspected or diagnosed with calcaneal fracture were imaged conventional scans with SCT, then 47 fractures diagnosed with intraarticular calcaneal fracture were farther postprocessed with the techniques of MPVR and SSD to classify the fractures and to show the condition of involvement of joints and the numbers of fragments and so on.Results Tuberosity slice showed the most involvement of articular facets in all cases. Coronal slice was superior to showing the medial and postenrior facets while involvment of the calcaneo-cuboid facets were defined most clearly in axial and tuberosity slice. The number of fragments was determined most reliably on the basis of the sagital reconstructions.The SSD version offered the spatial allocation of the individual slices, and well evaluated preoperatively the degree of joint injury and depression. Little displacement (only three fractures) of sustentaculum tali occurred. The severity of articular incongruity and rotational displacement of the posterior facet fragments were not well appreciated in coronal CT images of 11 fractures. Soft tissue abnormalities such as peroneal tendon could be clearly detected.Conclusion Spiral CT SSD and MPVR have important value in the diagnosis of calcanenl fracture, they play an important role in the preoperative classification of calcaneal fractures, and are useful for the selection of surgical approaches, and for the evaluation of prognosis.更多还原