·骨肌疾病·
横行致密带征象在MSCT诊断胸腰椎隐匿性骨折中的应用价值*
作者:钟永青 张飞冰 陈惠恩 梁 斌 陈学智 邬忠培 沈斯男
所属单位:广东省佛山市顺德区乐从医院放射科 (广东 佛山 528315)
PDF摘要
目的 探讨横行致密带征象在MSCT诊断胸腰椎隐匿性骨折中的诊断价值。资料与方法 对胸腰椎MSCT检查证实的隐匿 性骨折22例患者26个椎体的影像资料回顾性分析,分成对照组及实验组,对照组:仅观察常规横轴位软组织窗/骨 窗图像。实验组:仅观察MPR重组软组织窗/骨窗图像,双盲法分别认证统计各骨折征象(骨折线、骨小梁中断、骨 皮质中断、骨小梁集聚、骨皮质皱褶、横行致密带、软组织肿胀)。结果 首诊MSCT检查,对照组10个(38%)椎体骨 折,4个(15%)椎体见骨折线,3个(11%)椎体见骨皮质中断,8个(31%)椎体见骨小梁聚集。实验组26个(100%)椎体骨 折,4个(15%)椎体见骨折线,1个(4%)椎体见骨小梁中断,4个(15%)椎体见骨皮质中断,2个(7%)椎体见骨皮质皱 褶,26个(100%)椎体见横行致密带,其中15个(58%)椎体见唯一的横行致密带征象。首诊实验组隐匿性骨折诊断正 确率为100%,对照组隐匿性骨折正确率为38%。结论 横行致密带征象是MSCT诊断胸腰椎隐匿性骨折的重要征象之 一,可以是单纯性骨小梁微骨折的唯一征象。
Objective To evaluate the MSCT diagnosis value of transverse compact zone (CTZ) in thoracolumbar latent fracture. Materials and Methods The image data of 22 cases with 26 thoracolumbar latent fracture confirmed by multi-slice spiral CT were divided into control group, which were only observed the conventional horizontal axial soft tissue or bone window images, and experimental group, observed multiple planar reconstruction(MPR) soft tissue or lone window images respectively, and then all fracture sings such as fracture line, bone trabecular interruption, bone cortex interruption, bone trabecular cluster, bone cortical fold, transverse compact zone and soft tissue swelling were retrospectively analyzed. Results 10 cases of vertebral fractures, correctly in 38% in the first examination, including 4 cases of fracture line (in 15%), 3 cases of bone cortex interruption(in 11%) and 8 cases of bone trabecular cluster (in 31%) were found in control group. 26 vertebral fractures in 22 cases, correctly in 100% in the first examination, including 4 cases of fracture line(in 15%), 1 cases of bone trabecular interruption (in 4%), 4 cases of bone cortex interruption (in 15%), 2 cases of bone cortical hold (in 7%) and 26 transverse compact zone (in 100%) were found. Conclusion CTZ is one of the important signs for MSCT to diagnose thoracolumbar vertebra latent fracture and may be a sole sign in simple bone trabecular micro fracture.
【关键词】横行致密带; 隐匿性骨折; 螺旋CT; 图像重建
【中图分类号】R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2015.01.03
前言
胸腰椎椎体骨折是外伤的常见病,影像诊断的椎 体骨折征象包括骨折线、骨小梁中断、骨皮质中断、 骨皮质皱折,骨小梁聚集、周围软组织肿胀等,其中 骨折线是目前影像诊断骨折的金标准。既往认为隐匿 性骨折是X、CR/DR检查阴性而事实存在的骨折,随着多层螺旋CT(multi-slice spiral CT, MSCT)的多平 面重组(multiple planar reconstruction,MPR)的 广泛应用,常规CT、螺旋CT轴位无骨折线而MPR重组 存在横行致密带的隐匿性骨折并不少见。收集我院 2006.5~2013.12行胸腰椎螺旋CT(MSCT)检查证实隐匿性骨折的22例患者26个椎体的影像资料进行回顾性 分析,探讨横行致密带征象在MSCT诊断胸腰椎隐匿性 骨折的应用价值。
罕少疾病杂志
第22卷, 第 1 期
2019年11月
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