计算机辅助下腰椎CT图像自动化测量及其临床价值  

The utility of computer assisted automtic analysis for CT image of low lumbar spine

作　　者：边卫国[1] 党晓谦[1] 汤少杰[2] 宁文德[3] 彭磊[4] 徐华梓[4] 

机构地区：[1]西安交通大学第二医院骨外科,710004 [2]西安交通大学图像所,710049 [3]西安市中心医院影像科,陕西省西安市710004 [4]温州医学院附属第二医院骨外科,浙江省温州市325000

出　　处：《中国脊柱脊髓杂志》2007年第10期749-752,I0001,共5页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨计算机自动化测量下腰椎CT图像及其对腰椎管狭窄症的诊断价值。方法:应用Matlab自动测量程序对下腰椎CT图像进行自动分割和测量,完成对100例正常者和193例腰椎管狭窄症患者L4/5及L5/S1的椎管矢状径(APDC)、椎管面积(CAC)、硬膜囊面积(CAD)和硬膜外间隙(LAC)的测量,并进行统计学分析,利用正常组各项指标的95%下限值判断193例腰椎管狭窄症患者的狭窄节段,验证其诊断符合率。结果:腰椎管狭窄组L4/5及L5/S1两节段的APDC、CAC、CAD和LAC均显著小于正常组(P<0.01或0.001)。正常组L4/5的APDC、CAC、CAD和LAC的95%下限值分别为12.63mm、215.31mm^2、139.16mm^2和28.50mm^2,L5/S1分别为13.05mm、240.74mm^2、133.94mm^2和29.67mm^2。APDC、CAC、CAD和LAC对L4/5椎管狭窄的诊断符合率分别为63%、85%、82%和98%,对L5/S1分别为67%、86%、73%和96%。结论:计算机辅助下腰椎CT自动化测量精确、快速,可信度高,有助于腰椎管狭窄症的诊断。Objective：To develop a new computer analysis method for the measurement of CT images of low lumbar spine and to evaluate the diagnostic coincidence of this new method in diagnosing the lumbar spinal stenosis.Method：To develop a new computer analysis method for the measurement of CT images of low lumbar spine and to evaluate the diagnostic coincidence of this new method in diagnosing the lumbar spinal stenosis.Anterior-posterior diameter of the canal（APDC）, cross-sectional area of the canal （CAC）, cross-sectional area in the dura（CAD） and lib area of the canal（LAC） of L4-L5 and L5-S1 were measured and analysed.The 95% lower bounds value from each of the measure data of the normal control group was used as the guideline for diagnosing the lumbar stenosis by comparing with the data from the 193 cases of clinically diagnosed lumbar stenosis,and the reliability was test.Result：The APDC,CAC,CAD and LAC at L4/5 and LS/SI from the stenosis group were statistically less than those from the normal control group （P〈0.001）.The 95% lower bounds value of APDC,CAC,CAD and LAC at L4/5 was 12.63mm,215.31mm^2, 139.16mm^2 and 28.50mm^2 separately,while it was 13.05mm,240.74mm^2,133.94mm^2 and 29.67mm^2 separately at L5/S1.The diagnostic coincidence of APDC,CAC,CAD and LAC at L4/5 for lumbar stenosis was 63%, 85% ,82% and 98% correspondently,and it was 67%,86%,73% and 96% at L4/5.Conclusion：The computer program based on Matlab can be used for the measurement of CT images of low lumbar spine.The target data can be measured quickly and precisely with high reliability,which can be helpful in making the diagnosis of lumbar stenosis.

关 键 词：腰椎 测量 自动化 CT 形态学 

分 类 号：R681.5[医药卫生—骨科学] R814.42[医药卫生—外科学]