The Study On Three-dimensional Imaging Of Helical CT In Pelvic And Acetabular Fractures

The Study on Three-dimensional Imaging of Helical CT in Pelvic and Acetabular FracturesABSTRACTPelvic and acetabular fractures are serious and complicated injuries, resulted in accidents of traffic and trauma. Pelvic and acetabular fractures account for about lo/o--3% of all fractures, and second only fracture of limbs and spine. The incidence rate of hemorrhagic shock is higher than limbs and spine fractures. Pelvis and acetabular fractures are a significant source of morbidity and mortality. It is difficult for clinical treatment, so more conservative method are usually used. The incidence rate of deformed healing and traumatic arthritis was 5OO/o~~6O%. Owing to change of clinical viewpoint, more and more doctors and scholars advocate to active treatment for instable pelvis and acetabular fractures. The anatomic structure of pelvis and acetabulum is complex, and diagnosis and treatment planning of pelvis and acetabulum are liniited using X-ray. This is due to less than optimal image resolution, image distortion, and the presence of superimposed structures. The advent of computed tomography revolutionized diagnostic radiology. The transverse plane of CT is superior for the evaluation of rotation of the columns, and for the study of fractures of the posterior acetabular margin. CT improved the assessment of congruence between the femoral head and the aeetabulum, and yielded important information regarding to associated lesions of the sacroiliac joints and the presence intra-articular fragments. But the images only offer a two-dimensional view of the complex three-dimensional Pelvis and acetabuluni. Three-dimensional CT was created in late 1 970s, some scholars reported on the use of 3DCT for evaluation of acetabular fractures in late 1980s, and 3D imaging was shown to be beneficial. Some domistic scholars reported on the use of 3DCT for evaluation of acetabular fractures in late 1990s. At present, it is short of systematic and overall evaluation for the study on 3DCT-6-in Pelvis and acetabular fractUres.The purpose of this paper:l. To study the diagnoStic value of 3DCT aPplication to pelvis andacetabular fraCtUre2. TO study the role of 3DCT aPPlication in preoperative plaImin.3. TO identfy the role of 3DCT aPplication in evaluation of the effect ofsurgeryMaterials and Metbods:ll cases of pelvic trauma and 30 cases of acetabular trauma wereexamined with SIEMENS PLUS 4 helical CT All of the cases were scannedin suPine position transaxially with the gantry vertical. After data collection,the source images were post-processed on three-dimensional workstation andSIEMENS PLUS 4 spiral CT according to MPR' three-dimensional SSDand VRT techniques, and software program. The findings ofthree-dimensional SSD and VRT were analyzed and comPared with X-ray.2DCT. WR pre-operatively. 22 cases of acetabular fractUxe had gotSUrgical tretriellt. l2 cases were reconstructed in workstation withSSD. VRT post-opetalively and then compared with that of pre-operativelyResults:The anatomy of the pelvis and acetabulum is displayed clearly by 3Dimages, The "cot" method is gOod fOr pelvis and acetabulum, inicularsthce, joint SPace as they can not be readily identified by conventionalX-ray and 2DCT Analyzing 3-D SSD and VRT of 1lcases of pelvis, thefractWe quamity was 39. 44, While in X-ray plains. helical CT and MPR was34 and 44 and 44. FractUre detection rates of X-ray plains and SSD were77.3 and 88.6% respectively For 30 cases of acetabular fractures, thefractUre quantity of SSD and VRT was i58. l69,While in X-ray plains.helical CT and MPR was 133. l69 and 169. FractUre detection rates ofX-ray plains and SSD were 78.7and 93.5%.The difference with helical CT.eq--MPR. VRT was not talstically sighficant of pelvis and acetabularfractUres. but the quality of images displaying of the fractUre details with3DCT was better then X-ray plains. 2DCT. MPR. On the basis of images ofhelical CT 11 cases of pelvic fractUres were classified...