目的 探讨64排螺旋CT容积扫描 及三维重建技术在颌面骨折诊治中的应用 价值。方法 回顾性分析2016年3月-2018 年3月上海市第五人民医院收治的69例颌 面骨折患者的临床资料。所有患者均经 手术确诊，且于术前接受64排螺旋CT扫 描检查，将数据传送至工作站进行三维 重建。观察患者颌面骨折部位分布情况， 比较CT平扫和三维重建对骨折的检出率差 异性，术后3个月对患者进行复查，观察 术后恢复情况。结果 69例颌面骨折患者 手术发现骨折156处，多发性骨折41例， 上颌骨、下颌骨骨折最为常见，蝶骨、眉 骨、筛骨骨折最为少见；CT三维重建对 颌面骨折的检出率为96.79%(151/156)， 高于CT平扫检出率84.62%(132/156) (χ2 =13.724，P﹤0.05)。结论 64排螺旋 CT三维重建对颌面骨折有较高的诊断价 值，检出率高于CT平扫，且能准确评估术 后内固定和恢复情况。

Objective To explore the application value of 64-slice spiral CT volume scan and three-dimensional (3D) reconstruction in the diagnosis and treatment of maxillofacial fractures. Methods The clinical data of 69 patients with maxillofacial fractures admitted to Shanghai Fifth People's Hospital from March 2016 to March 2018 were retrospectively analyzed. All patients were diagnosed by surgery, and they were given 64-slice spiral CT scan before surgery. The data were transmitted to the workstation for 3D reconstruction. The distribution of maxillofacial fractures sites was observed, and the detection rates of fractures between CT and 3D reconstruction were compared. The patients were reviewed at 3 months after operation, and the postoperative recovery was observed. Results Among 69 patients with maxillofacial fractures, there were 156 fractures founded by surgery, and 41 cases were with multiple fractures. The maxillary fractures and mandibular fractures were the most common, and the sphenoid bone, brow bone and ethmoid fractures were the least common. The detection rate of CT 3D reconstruction for maxillofacial fracture was higher than that in CT plain scan [96.79% (151/156) vs 84.62% (132/156) (χ2 =13.724, P<0.05). Conclusion Three-dimensional reconstruction of 64-slice spiral CT has a high diagnostic value for maxillofacial fractures, and it detection rate is higher than that of CT plain scan, and can accurately evaluate the postoperative internal fixation and recovery.