论文部分内容阅读
目的:探讨64排螺旋CT扫描、多平面重组及三维容积重建在胸腰椎损伤分型和严重程度TLICS评分系统的价值。材料与方法:回顾性分析2014年10月至2016年10月期间的50例胸腰椎损伤患者,其中男性27例,女性23例,平均年龄(44±9.8)岁。所有患者均行64排螺旋CT扫描,采用矢状位MPR和三维容积再现(VR)技术进行处理,根据典型CT表现推断后方韧带复合体的损伤情况,并且利用胸腰椎损伤TLICS系统进行评分,TLICS分值>4分的病例通过手术证实。结果:50例胸腰椎损伤患者中,共检出76个椎节骨折和14例后方韧带复合体(PLC)损伤,其中单纯压缩型18例,爆裂型28例,平移/旋转型20例,牵张型10例;后方韧带复合体(PLC)损伤的CT表现有棘突撕脱骨折5例,椎体平移和旋转3例,关节突横行骨折2例,小关节脱位2例,棘突间隙增宽合并小关节脱位1例,棘突间隙增宽伴关节突骨折1例。结论:通过多平面重组及三维VR技术能有效检出骨折与脱位,提示PLC损伤,可作为胸腰椎损伤重要的检查手段之一,尤其是对于急诊患者,早期可用来指导临床进行TLICS评分。
Objective: To investigate the value of 64-slice spiral CT scan, multiplanar reconstruction and three-dimensional volume reconstruction in the classification and severity of thoracolumbar injuries TLICS scoring system. MATERIALS AND METHODS: Fifty patients with thoracolumbar injuries from October 2014 to October 2016 were retrospectively analyzed. There were 27 males and 23 females, with an average age of 44 ± 9.8 years. All patients underwent 64-slice spiral CT scan, and treated with sagittal MPR and three-dimensional volume rendering (VR). The damage of the posterior ligament complex was deduced from the typical CT findings. TLICS scores of the thoracolumbar spine injuries, Score> 4 points confirmed by surgery. Results: Totally 76 vertebral fractures and 14 posterior ligament complex injuries were detected in 50 cases of thoracolumbar spine injuries. There were 18 cases of simple compression type, 28 cases of burst type and 20 cases of translational / rotation type Zhang type 10 cases; posterior ligament complex (CT) injury CT showed spinous process avulsion fracture in 5 cases, vertebral translation and rotation in 3 cases, 2 cases of transverse degeneration in the facet joint, small joint dislocation in 2 cases, A case of wide merger and dislocation of the facet joint, a widened interspinous process gap with osteotomy in 1 case. CONCLUSIONS: Fracture and dislocation can be effectively detected by multiplanar reconstruction and three-dimensional VR. It is suggested that PLC can be used as an important examination method for thoracolumbar spine injuries. Especially for emergency patients, it can be used to guide the clinical TLICS score.