论著-头颈部
螺旋CT扫描及多平面重建(MPR)技术在骶尾部病变诊断中的应用*
作者:上官建伟1 梁俊芳1 肖新广1 张新明1 刘玉珂2
所属单位: 1.郑州大学附属郑州中心医院放射 科 (河南 郑州 450007) 2.河南省洛阳正骨医院放射科 (河南 洛阳 471002)
PDF摘要
目的 探讨螺旋CT扫描及多平面 重建(MPR)技术在骶尾部病变诊断中的应 用价值。方法 将2014年5月-2016年4月因 骶尾部疼痛入院就诊的64例患者作为研究 对象,均拍摄骶尾骨正侧位DR片和螺旋CT 骶尾部扫描,采用MPR技术对CT图像进行 重建。结果 正侧位DR片显示54例无骨质 异常,10例疑似骨折;经螺旋CT及MPR技 术重建后,2例疑似骨折,14例骨折,8例 肿瘤,1例发育异常。16例骨折或疑似骨 折患者中,12例骶骨部周围软组织肿胀, 6例有明显骨折线。8例骶尾部肿瘤(经临 床病理证实),5例骶骨脊索瘤,骶骨溶骨 性破坏,有分叶状软组织肿块,部分周围 脏器受压,瘤体内有钙化点;3例巨细胞 瘤,骶骨骨质呈皂泡样破坏,周围有软组 织肿块,边界清晰,周围结构有推移,与 周围正常骨质移行带变窄;1例骶骨神经 纤维瘤,相应骶孔扩大,骶前组织肿块, 边界清晰。1例发育异常可见骶骨部透亮 带。结论 螺旋CT扫描及多平面重建MPR技 术可为临床诊治骶尾部病变提供丰富信 息。
Objective To explore the application value of spiral CT scan and multiplanar reconstruction (MPR) technique in the diagnosis of sacrococcygeal diseases. Methods 64 cases of patients with sacrococcygeal pain who were admitted into our hospital between April 2013 and April 2015 were enrolled in the study. The positive side and left-right oblique position DR films of sacrococcyx of all patients were took and all patients underwent spiral CT scanning of sacrococcyx. The CT images were reconstructed by MPR technique. Results The positive side and left-right oblique position DR films showed that there were no bone abnormalities in 54 cases, and 10 cases with suspected fractures; After spiral CT and MPR technique, there were 2 cases with suspected fractures, 14 cases with fractures, 8 cases with tumors and 1 case with abnormal development. Among 16 cases of patients with fractures or suspected fractures, there were 12 cases with soft tissue swelling around sacrum and 6 cases with obvious fracture line. 8 cases had sacrococcygeal tumors (confirmed by clinical pathology). 5 cases had sacral chordoma, sacral osteolytic destruction, lobulated soft tissue masses, localized surrounding organs compression and calcification in tumors. 3 cases had giant cell tumors, and the sacral bone showed soap bubble-like destruction, surrounded by soft tissue masses, with clear boundaries, shift of the surrounding structures, and the surrounding normal bone transition zone narrowing; 1 case had sacral neurofibroma, with enlargement of corresponding sacral foramen, with anterior sacral tumor with clear boundary. 1 cases of abnormal sacral development showed radiolucent zone. Conclusion Spiral CT scan and MPR technique can provide abundant information for clinical diagnosis and treatment of sacrococcygeal lesions.
【关键词】骶尾部;X线计算机;体层摄 影技术;多平面重建
【中图分类号】R323.4+6
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.07.041
前言
骶尾部外伤、肿瘤等病变均会引起骶尾部疼痛,以往临床常拍摄 骶尾部正侧位DR片进行疾病诊断,然而,骶尾部位置较深、解剖结构 复杂、先天变异大,加之盆腔脏器、积粪、肠气等因素的影响,部分 患者的骨折线往往无法清晰显示,增加了临床诊断难度[1]。此外,DR 片无法清楚显示骶尾部软组织病变,漏诊、误诊率较高。多层螺旋CT 具有无创、扫描时间短等优势,且后处理技术强大,选择适当后处理 层厚可清楚显示骶尾部骨折线,提高诊断准确率,为临床诊治骶尾部 病变提供资料[2]。对此,本文分析了多层螺旋CT及MPR技术在骶尾部病 变诊断中的应用价值,旨在提高诊断准确率指导临床治疗,现报道如 下。
中国CT和MRI杂志
第15卷, 第 7 期
2017年07月
相关文章