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目的比较锥形束电子计算机断层扫描(cone beam computed tomography,CBCT)与X线全景片、螺旋CT对下颌骨髁头骨折的诊断和分型结果,探讨CBCT的应用价值。方法回顾作者医院2016-01~12月经治下颌骨髁头骨折病例21例(27侧),均应用CBCT扫描,CBCT检查前已行X线全景片检查13例,行颅颌CT扫描11例(3例同时有全景片)。比较分析各检查方法的诊断率和分型率。结果 CBCT在髁头骨折的诊断率与X线全景片、CT冠状位扫描或三维重建比较差异均无统计学意义(P>0.05),但明显高于水平位CT,二者比较差异有统计学意义(P<0.05);CBCT的分型率高于X线全景片和水平位CT,比较差异均有统计学意义(P<0.05),与CT冠状位扫描或三维重建比较差异无统计学意义(P>0.05)。27侧(21例)确诊髁头骨折中,分别发生在髁突外的A型骨折11侧、B型骨折9侧、C型骨折者2侧,M型粉碎性骨折5侧。结论 CBCT能直观、立体、多方位显示下颌骨髁头骨折,在其诊断、分型和临床处理中具有重要价值。
Objective To compare the diagnostic and classification results of cone beam computed tomography (CBCT) with X-ray panoramic and spiral CT in the diagnosis of mandibular condyle fractures and to explore the value of CBCT. Methods The authors reviewed 21 cases (27 sides) of the mandibular condyle fracture in the author hospital from January 2016 to December 2011. All of them were examined by CBCT. Thirteen cases were examined by X-ray before CBCT, 3 cases at the same time panorama). Comparative analysis of the diagnostic methods and the classification rate. Results The diagnostic rates of CBCT in condylar head fractures were not significantly different from those of X-ray films, CT coronal scan or three-dimensional reconstruction (P> 0.05), but significantly higher than that of CT (P <0.05). The classification rate of CBCT was higher than that of X-ray panoramic film and horizontal CT (P <0.05), but there was no significant difference between CT and CT scan or 3D reconstruction (P> 0.05). In the 27 sides (21 cases), condylar fractures were identified in 11 cases of type A fractures, 9 cases of type B fractures, 2 cases of type C fractures and 5 types of M type comminuted fractures. Conclusion CBCT can show the mandibular condyle fracture in an intuitive, stereoscopic and multidirectional manner, which is of great value in diagnosis, classification and clinical treatment.