多探测器计算机断层扫描在颌面部损伤评估中的应用

P. Agarwal, Deepak Ramnani, A. Tambi
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摘要

面部损伤在创伤患者中占很大比例,需要及时诊断和处理。由于交通流量的增加,颌面外伤的数量不断增加,在交通中不采取预防措施导致道路交通事故,是导致颌面骨折的主要原因。目的:探讨多探测器断层扫描在颌面部损伤诊断中的作用。描述三维重建图像相对于轴向图像在面部骨折成像中的优势。这项横断面研究包括100名患者,他们在2019年2月至2020年7月期间在乌代普尔Geetanjali医学院和医院的64层体积扫描仪(SIEMENS SOMATOM定义)上出现颌面骨骨折的证据时接受了面部骨骼的CT评估。RTA占76.19%。攻击和高空坠落的比例分别为11.42%和12.38%。上颌窦壁是最常见受累骨,占71.42%,其次是鼻眶筛骨,占68.57%。颧骨骨折占50%,下颌骨骨折占38.09%。2型额骨骨折12例(31.5%),3型10例(26.02%),4型和1型6例(15.7%),5型最少(10.52%)。眼眶内侧壁最常受累49例(35.76%)。Le Fort骨折线17例,其中Le Fort II型9例(52.9%)。三维图像在面部创伤评估中的优势可以描述,特别是在下颌骨和颧骨。三维图像对Le Fort断裂线的识别效果较好。冠状面重建图像在眶部和上颌骨骨折的检测上具有优势。三维图像在涉及鼻眶筛骨区的骨折以及骨折位移最小的情况下的作用有限。
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Multidetector computed tomography in evaluation of maxillofacial injuries
Facial injuries occur in significant proportion in trauma patients requiring prompt diagnosis and management. The number of maxillofacial injuries is continuously increasing due to rise in traffic, failure to take preventive measures in the traffic leads to road traffic accidents, which is the main etiological factor in maxillofacial fractures. To study role of multidetector tomography in evaluation of maxillofacial injuries. To describe the advantages of 3D reconstructed images over axial images in the imaging of facial fractures. This cross-sectional study included 100 patients who underwent CT evaluation of facial bones when they presented with evidence of fracture of maxillofacial bones on a 64-slice volume scanner (SIEMENS SOMATOM definition) in Geetanjali Medical College and Hospital, Udaipur during February 2019 to July 2020. RTA comprised of 76.19% cases. Assault and fall from height were 11.42 and 12.38%. The maxilla, the walls of its sinus were the most commonly involved bone with 71.42% next was Naso-orbito-ethmoid 68.57%. Zygomatic bone and mandible fractures were 50 and 38.09%. The type 2 frontal bone fractures were commonly seen 12 (31.5%) followed by Type 3, 10 (26.02%), Type 4 & Type 1 seen in 6 (15.7%) and Type 5 was the least common injury seen 4 (10.52%). The medial wall of the orbit was most commonly involved 49 (35.76%). Le Fort fracture lines were identified in 17 occasions with Le Fort II seen 9 (52.9%). The advantages of 3D images within the assessment of facial trauma might be described especially in mandible and cheekbone. 3D images were better within the identification of Le Fort fracture lines. The coronal reconstructed images are superior in the detection of fractures in the orbit and maxilla. 3D images have a limited role in fractures involving the naso-orbito-ethmoid region and also when there is minimal fracture displacement.
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