本文選題：鼻骨骨折 + 體層攝影術(shù)��； 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的 鼻骨骨折在頜面部外傷中多見,以往鼻骨骨折的診斷主要依賴X線平片或常規(guī)CT檢查,X線平片能檢出多數(shù)鼻骨骨折,但由于普通X線平片檢查受投照體位、部位重疊以及密度分辨率較差等的影響,有時(shí)鼻骨骨折容易漏診；常規(guī)CT的軸位或冠狀位檢查時(shí),常難以使雙側(cè)結(jié)構(gòu)對(duì)稱,受到患者外傷的限制常難以做冠狀位掃描,另外受到層厚的限制,易將正常結(jié)構(gòu)誤診為骨折或?qū)⒓?xì)微骨折漏診,延誤患者的治療或?qū)λ痉ㄨb定帶來困惑。本文利用多層螺旋CT (MSCT)各向同性掃描的特征,探討多層螺旋CT后處理技術(shù)在鼻骨骨折的臨床應(yīng)用價(jià)值。 方法 對(duì)115例鼻外傷患者的多層螺旋CT原始圖像進(jìn)行MPR和VR后處理,將鼻骨骨折分為單純Ⅰ型(線性骨折無移位或成角),單純Ⅱ型(線性骨折伴移位),粉碎型骨折(單側(cè)或雙側(cè)鼻骨碎成三塊及以上,即兩條或兩條以上貫通性骨折線),復(fù)合型骨折(鼻骨骨折合并周圍骨骨折),骨縫分離型(骨縫大于2mm或縫隙骨兩端錯(cuò)位),將單純的鼻淚管和上頜骨額突骨折也納入統(tǒng)計(jì)范圍,是考慮鼻外傷多有或伴有上頜骨額突等骨折。另外收集83例無鼻部外傷患者(主要是進(jìn)行副鼻竇CT檢查)分別采用骨和軟組織算法進(jìn)行MPR和VR后處理以觀察正常鼻骨骨縫、鼻骨的骨性孔道和鼻骨的形態(tài),同時(shí)對(duì)骨和軟組織算法的VR逼真程度進(jìn)行對(duì)比。 結(jié)果 鼻骨骨折患者91例。單純Ⅰ型9例；單純Ⅱ型6例；粉碎型骨折5例；復(fù)合型骨折57例,其中合并眶骨骨折32例、鼻中隔骨折9例、鼻淚管骨折8例和上頜骨額突骨折44例；骨縫分離型23例,其中額頜縫分離1例,鼻頜縫分離22例；單純上頜骨額突骨折11例；骨折累及鼻骨孔2例,骨折累及上頜骨額突根部血管神經(jīng)孔3例；眼肌損傷1例,球后出血1例。骨算法VR在頜面部骨縫及骨孔顯示方面優(yōu)于軟組織算法,二者對(duì)鼻中間縫、鼻額縫、鼻頜縫、鼻骨孔顯示為優(yōu)的百分率分別47.0%vs0%；91.6%vs9.6%；72.3%vs12.0%；84.3%vs3.6%。鼻骨常見類型35例,表現(xiàn)為鼻骨尖部平直；鼻骨下緣變異48例,分為四種類型：單側(cè)鼻骨的倒V字型、雙側(cè)鼻骨的M型缺口、裂隙樣、鋸齒樣,分別為16例、29例、2例、1例。 結(jié)論 MPR圖像結(jié)合骨算法的VR圖像在顯示鼻骨正常結(jié)構(gòu)、變異及鼻骨多發(fā)骨折中具有重要價(jià)值,特別有益于區(qū)分鼻骨孔、骨縫、鼻骨變異與無明顯移位的線性骨折,使診斷更加準(zhǔn)確、完善,為治療提供了更好的依據(jù)。
[Abstract]:Purpose Nasal fracture is more common in maxillofacial trauma. In the past, the diagnosis of nasal fracture mainly depended on X-ray plain film or conventional CT examination. Because of the influence of overlap of position and poor density resolution, it is easy to miss diagnosis of nasal bone fracture, and it is difficult to make bilateral structure symmetrical in axial or coronal examination of conventional CT, so it is difficult to do coronal scan because of the limitation of patients' trauma. In addition, due to the limitation of layer thickness, the normal structure is easily misdiagnosed as fracture or fine fracture is missed, which delays the treatment of patients or brings confusion to judicial identification. Based on the isotropic features of multislice spiral CT (MSCT), the clinical value of multislice spiral CT post-processing in nasal fracture was discussed. Method MPR and VR postprocessing were performed on the original images of multislice spiral CT in 115 patients with nasal trauma. The nasal bone fracture was divided into simple type 鈪，

本文編號(hào)：1784437