刘秀，杨雄雄，文玲，杜桂华

(南充市中医医院放射科，四川 南充　637000)



MSCT在椎体附件微小骨折的临床价值

刘秀，杨雄雄，文玲，杜桂华

(南充市中医医院放射科，四川 南充637000)

目的：探讨MSCT在椎体附件微小骨折的临床价值。方法：回顾性收集2014年3月至2015年3月脊柱椎体附件微小骨折59例，所有病例均行多层螺旋CT检查(multislice spiral computed tomog-raphy，MSCT)采用三维重建(virtual reality，VR)和多平面重建(multiple planar reconstruction，MPR)技术观察。两名诊断医师采用双盲法分别对59例病例进行观察分析，若两者意见不一致经协商达成一致，采用统计学方法对相关数据进行分析。结果：59例病例中椎板骨折17例(合并椎体骨折11例)，横突骨折29例(合并椎体骨折9例)，棘突骨折13例(合并椎体骨折13例)。采用MPR、VR和横断位两两比较，三者间对微小骨折的检出率均没有统计学意义(37/59,32/59，26/59,P>0.05)。采用轴位(AX)+MPR、AX+VR分别与横断位比较，两者间对微小骨折检出率均有统计学意义(81.3% vs.44.1%，77.9 vs.44.1%，P<0.05)。采用AX+MPR和AX+VR比较，两者间对微小骨折检出率无统计学意义(81.3% vs.77.9%，P>0.05)。结论：MSCT检查联合VR或MPR后处理技术，对椎体附件微小骨折的诊断价值优于单纯常规横断位检查。图像后处理技术的综合运用可降低椎体微小骨折的漏诊率。

椎体骨折；多层螺旋CT；三维重建；多平面重建

【Abstract】Objective：To explore the clinical value of diagnosis of tiny fractures in the vertebral body attachment by applying MSCT imaging.Methods：A total of 59 cases of tiny fractures in spinal vertebral body attachment were retrospectively collected from March 2014 to March 2015,and all cases were examined by Multi-slice CT examination (multi-slice spiral computed tomography,MSCT).Virtual Reality (VR)and multiplanar reconstruction (multiple planar reconstruction,MPR)technology were adopted.Two diagnostic doctors observed and analyzed the 59 cases by double blind methods,respectively.If both of them disagreed,they would come to agreement through consultation and analyze the relevant data by statistical methods.Results：In the 59 cases,there were 17 cases with vertebral plate fracture (11 cases of merge vertebral fractures),and 29 cases with transverse process fracture (9 cases of vertebral fractures),and 13 cases with spine fractures (13 cases of vertebral fractures).Comparing the examination results by MPR and VR and cross sectional,the tiny fracture detection rates were not statistically significant (37/59,32/59,26/59,P>0.05).However,the tiny fracture detection rate had statistical significance by using AX + MPR,AX + VR with transection,respectively (81.3% vs.44.1%，77.9 vs.44.1%,P<0.05).Comparing the examinations by using AX + MPR and AX + VR,There is no statistical significance between the two observers’ finding(81.3% vs.44.1%，P>0.05).Conclusion：The value of the diagnosis of vertebral body annex tiny fractures by combination of MSTC and VR or MPR is superior to the conventional cross sectional examination.The integrated use of post-processing image can reduce the missed diagnosis of tiny fractures in vertebral body.

【Key words】Vertebral body fracture;Multi-slice CT;Virtual Reality(VR)；Multiplanar planar reconstruction (MPR)

脊柱椎体附件微小骨折是脊柱中常见的外伤之一[1]，利用常规X线检查虽是脊柱外伤的首选检查方法，但对于细微骨折，容易漏诊、误诊。随着多排螺旋CT (multi-slice spiral computed tomography，MSCT )的发展，多平面重建(multiple planar reconstruction，MPR)、三维重建(virtual reality，VR)等后处理软件的联合应用，诊断率不断提高，使得CT检查明显提高了脊柱创伤诊断的准确性。研究收集2014年3月至2015年3月本院59例椎体附件微小骨折行MSCT检查的重建进行分析。探讨……