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目的评价多层螺旋CT多平面重建(multi-planar reconstruction,MPR)及最大密度投影(maximum intensity projection,MIP))在诊断脊柱爆裂性骨折中的应用价值。方法45例(53个脊柱)脊柱爆裂性骨折患者,行64层螺旋CT横断位容积扫描,多平面重建横断、矢状、冠状切面的二维图像及三维的MIP成像,分析比较各图像显示骨折详细情况的能力。结果横断切面图像显示椎体纵、横形多处或单处骨折49个(92.5%),骨折片向后突入椎管,椎管狭窄34个(64.2%);矢状切面图像显示脊柱后突畸形28例(62.2%);矢状切面图像及冠状切面图像显示椎体前后部高度压缩37个(69.8%),椎体上终板或(和)下终板局部骨折塌陷19个(35.8%)。共44处脊柱附件骨折,横断切面明确诊断39处,矢状切面显示35处,冠状切面显示33处。MIP成像直观显示所有骨折脊柱的空间结构及椎体间的旋转脱位6个(11.3%)。结论多层螺旋CT的MPR及MIP成像技术相互补充,对脊柱爆裂性骨折的诊断及临床治疗有重要价值。
Objective To evaluate the value of multi-planar reconstruction (MPR) and maximum intensity projection (MIP) in the diagnosis of spondylolisthesis fracture. Methods Forty-five patients (53 spine) with spina bifida fractures were examined by 64-slice spiral CT scans, multi-planar reconstruction of two-dimensional images of cross-sectional, sagittal and coronal sections and three-dimensional MIP imaging. Ability to detail the situation. Results The transverse section of the vertebral body showed 49 vertebral bodies (92.5%) with multiple longitudinal or transverse fractures or single fractures. The fractures flared back into the vertebral canal and spinal canal stenosis was 34 (64.2%). The sagittal images showed kyphosis The sagittal images and coronal images showed that the anterior and posterior vertebral bodies were highly compressed by 37 (69.8%) and the vertebral endplates (or lower endplates) collapsed 19 (35.8%). . A total of 44 spinal accessory fractures, cross-section clear diagnosis of 39, sagittal section showed 35, coronal section showed 33. MIP imaging showed the spatial structure of all fractured spine and rotational dislocation of the vertebral body 6 (11.3%). Conclusions Multi-slice spiral CT (MPR) and MIP imaging are complementary to each other and have important value in diagnosis and clinical treatment of burst fractures of the spine.