1、Diagnostic Radiology Of Maxillofacial,Part of Injury,吴红兵,Most common responsible,Fall Automobile accident Blows from foreign bodies strking Others,头部、颌面部受伤的处理,危险的颅内出血。 意识消失或神智模糊,呼吸困难,呕吐,抽搐,手脚麻痹,口或鼻腔流血或透明的液体,剧烈头痛持续不止等等。 原则:先处理颅脑症状,稳定全身生命体征,后治疗颌面部损伤。,Applied radiology,The prescription of appropriate f
2、ilm can be made only after a careful clinical examination,Radiology aids in identifying the location and orientation of fractures and indicates the degree of separation or displacement of fracture margins.,Radiographs are very useful after an injury,Test technics,Waters position (华氏位、鼻颏位)Panoramic 曲
3、面断层片(全景)Cephalometric (X线头影测量片)or lateral film(侧位片)Occlusal film咬合片Submentovertex (颅底位、颏顶位、颧弓位)Zygomatic bone-PA(颧骨后前位、顶颏位)Postanterior position(下颌骨后前位)Obligue lateral projection(下颌骨斜侧位)Schullars position (薛氏位、颞下颌关节片)CT and MRI,Diagnostic principle,1. position and number 2. types 3. displacement 4.
4、relation between the fracture line and teeth 5. differentiate from nutrition canal and normal sutures 6. concrescence of fractures,position and number of fractures,Types,Displacement,relation between the fracture line and teeth,differentiate from nutrition canal and normal sutures,Alveolar fracture,
5、Alveolar fracture company with tooth inlay,Maxillary fracture,Fracture Types of maxillar boneLefortLefort Lefort ,Lefort,(horizontal fracture ),Lefort ,Lefort ,Lefort fracture,Waters position,Right-lefort ,left-lefort and,Waters position,(眶-上颌-颧骨OMZ、复合骨折),Fractures of Zygomatic bone and arch,After o
6、peration,Comminute Fracture of zygomatic arch,“M” type of submentovertex,Fracture of nose bone,Pay attention to the maxillary bone fracture!,1、双侧眼眶及上颌窦大小不一,窦腔积液昏暗 2、骨折线多样,骨折块移位,左右眶下缘不在、同一水平 3 、牙弓不对称 4、颌间间隙形态不对称 5、张口受限是否由于喙突受压? 6、骨折是否波及颅及颅底?,Fracture of mandible,The most ommon fracture sitesmentalbod
7、yanglecondyle and its neck,Classification of the condyle fracture,Please look at book P158P161,Panoramic view,Panoramic view,Panoramic view,Panoramic view,Panoramic view,Panoramic view,Postanterior position(PA),Postanterior position,CT view,3D dimension reconstruction,Tomographic view and CT-3D,Pathologic fracture,Oriented from tumors ,Osteomyelitis, tooth extraction, operation etc.,陈旧性骨折,X-ray appearance time,异物定位,横向位片 轴向位片 定位针,Questions ?,骨折后1-2月照片发现原来的骨折线更加变宽,为什么? 上颌骨骨折引起张口受限在X线片上主要可观察到什么征象? 成人和儿童髁突骨折有哪些不同? 髁突骨折有哪些种类? 全景片上的髁突骨折和后前位有哪些不同? 什么情况下容易引起误诊?,The end,Thank you !,