三度空間電腦斷層在顎顏面骨折之應用（臨床報告）

The Application of three-dimensional Computed Tomography in Maxillofacial Fractures

李曉屏(Shiao-Pieng Lee) ； 阮春榮(Chun-Jung Juan) ； 夏毅然(Yi-Jan Hsia) ； 張燕清(Yen-Ching Chang)

《中華民國口腔顎面外科學會雜誌》 10卷1期 (1999/03) Pp. 38-47

https://doi.org/10.7104/CJOMS.199903.0038

摘要

放射線檢查爲評估顎顔面骨折的重要輔助診斷工具。與傳統的X光攝影及電腦斷層(2-D CT)相較，三度空間電腦斷層(3-D CT)提供了立體的影像，立體影像所呈現的與肉眼目視的實景一樣，診斷方便性與實用性較佳；而整個顱顔區骨折，可在一張影像上一覽無遺，診察的範圍較廣；骨折後兩端骨頭移位的方向、角度及程度可一目瞭然，診斷的精確性亦較好。本文根據實際應用3-D CT在本院顎顔面骨骼外傷的病例，說明此一新穎之影像檢查利器在診斷上的優勢，同時建議可選擇3-D CT使用在顎顔面區某些較複雜及較特殊的骨折，如粉碎性骨折、矢狀分裂性骨折、髁狀突骨折、泛顔面骨骨折、眼眶下綠骨折等，來獲得更有助於診斷之影像。但3-D CT有重組影像費時，影像解晰度較差等缺點；而且眼眶內側部、篩骨與副鼻竇等骨折，無法在3-D CT影像清楚顯示出來，此時2-D CT仍為另一選擇。

關鍵字

顎顏面骨折 ； 三度空间電腦斷層

並列摘要

Radiographic examination is an adjuvant but very important diagnostic tool in evaluation of fractures of the facial skeleton. The 3-D CT provides a stereography which displays a global view of the face as seen by eyes and the entire craniofacial fractures in one film. It can be used to evaluate the direction, angulation and degree of the displacement of the bone fragments in reference to the surrounding structures. Thus, it provides better diagnostic accuracy than conventional plain films do. Based on the experience of using 3-D CT for the cases with maxillofacial trauma at TSGH, we discuss the new imaging modality. We found it very useful in providing additional information in some complex and specific fractures, such as comminuted fractures, sagittal splitting fractures, mandibular condylar injuries, panfacial fractures and infraorbital fractures. We suggest that these are the optional indications for 3-D CT. The disadvantages of 3-D CT are reduction in resolution and time consuming in image reconstruction. Besides, the 3-D CT is not suitable to evaluate very thin bones, such as the bony fractures of medial orbital portion, ethmoid and paranasal sinus because they are hard to be visualized and interpreted from 3-D CT.