口腔医学研究

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (7): 746-750.DOI: 10.13701/j.cnki.kqyxyj.2018.07.015

• 口腔数字化影像技术研究 • 上一篇    下一篇

螺旋CT三维重建和MRI在下颌骨髁突骨折中的临床应用比较

雷欣1,2*, 邓书海2, 关崧华2, 黄辉2, 陈玉婷2, 刘虹2   

  1. 1. 深圳市龙华区中心医院口腔科 广东 深圳 518110;
    2. 南方医科大学附属南海医院口腔科 广东 佛山 528200
  • 收稿日期:2018-01-12 出版日期:2018-07-28 发布日期:2018-07-20
  • 通讯作者: 雷欣,E-mail:leixin8619@sina.com
  • 作者简介:雷欣(1986~ ),女,江西人,硕士,主治医师,主要 从事口腔医学临床工作。
  • 基金资助:
    佛山市自筹经费类科技计划项目(市医学类科技 攻关项目)(编号:2017AB000232)

Comparison of Spiral CT Three-Dimensional Reconstruction and MRI in Fracture of Mandibular Condyle

LEI Xin1,2*, DENG Shu-hai2, GUAN Song-hua2, HUANG Hui2, CHEN Yu-ting2, LIU Hong2   

  1. 1. Department of Stomatology, Central Hospital of Longhua District of Shenzhen, Shenzhen 518110, China;
    2. Department of Stomatology, Nanhai Hospital Affiliated to Southern Medical University, Foshan 528200, China.
  • Received:2018-01-12 Online:2018-07-28 Published:2018-07-20

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摘要： 目的:探究螺旋电子计算机断层扫描(computed tomography,CT)三维重建和核磁共振(magnetic resonance imaging,MRI)在下颌骨髁突骨折中的诊断价值。方法:选择本院收治的69例疑似髁突骨折病例作为研究对象,患者均进行三维螺旋CT、MRI检测,观察患者髁突骨折类型、移位情况、软组织损伤情况,以患者术中诊断作为评定金标准,对比CT、MRI诊断髁突骨折类型、移位类型、软组织损伤诊断效能。结果: CT检测Ⅰ类骨折65.22%,Ⅱ类骨折21.74%,Ⅲ类骨折13.04%,MRI结果显示,Ⅰ类骨折占71.01%,Ⅱ类骨折占17.39%,Ⅲ类骨折占11.59%;CT检测骨折移位Ⅰ型39.13%,Ⅱ型28.99%,Ⅲ型31.88%;MRI检测Ⅰ型36.23%,Ⅱ型26.09%,Ⅲ型37.68%;CT、MRI骨折类型、移位类型检出对比无明显差异;MRI在骨髓水肿方面检出率明显高于CT(P＜0.05)。以手术诊断作为评定金标准,MRI检测骨髓水肿准确度、灵敏度、特异度均明显高于CT(P＜0.05)。结论: CT、MRI在检测髁突骨折类型以及骨折移位类型方面准确度均较高,两种影像学检测诊断价值相似,MRI还可有效反应患者关节囊内损伤情况,可用于下颌骨髁突骨折软组织损伤检测。

关键词: 下颌骨髁突骨折, 螺旋CT三维重建, 核磁共振, 骨折类型, 骨折移位, 诊断效能

Abstract: Objective: To explore the diagnostic value of spiral CT three-dimensional reconstruction and magnetic resonance imaging (MRI) in the fracture of mandibular condyle. Methods: Sixty-nine cases of suspected condylar fracture that treated in our hospital were selected. All patients were detected by three dimensional spiral CT and MRI. The type, displacement, and soft tissue injury of the condylar fracture were observed. The intraoperative diagnosis was used as the gold standard of assessment. The diagnostic efficacy of CT and MRI in the diagnosis of condylar fracture type, displacement type, and soft tissue injury was compared. Results: CT detection showed that Ⅰ class fracture was 65.22%, Ⅱ class fracture was 21.74%, and Ⅲ class fracture was 13.04%. MRI test results showed that Ⅰ class fractures accounted for 71.01%, Ⅱ class fractures accounted for 17.39%, and Ⅲ type fractures accounted for 11.59%. CT detection showed the types of condylar fracture displacement type Ⅰ was 39.13%, type Ⅱ was 28.99%, and type Ⅲ was31.88%. MRI showed type Ⅰ was 36.23%, type Ⅱ was 26.09%, and type Ⅲ was 37.68%. There was no significant difference between the type of fracture and the type of displacement between CT and MRI. The detection rate of MRI in bone marrow edema was significantly higher than that of CT (P<0.05). Taken the operative diagnosis as the gold standard, the accuracy, sensitivity, and specificity of MRI in the detection of bone marrow edema were significantly higher than that of CT (P<0.05). Conclusion: The accuracy of CT and MRI in detecting the types of condylar fracture and fracture displacement types is similar. MRI can also effectively respond to intraarticular capsule injury in patients, and can be used to detect the soft tissue injury of the mandibular condylar fracture.

Key words: Mandibular condyle fracture, Three dimensional reconstruction of spiral CT, Nuclear magnetic resonance, Type of fracture Fracture, displacement Diagnostic efficiency