多层螺旋CT多平面重组测量胸腰段骨折后凸角的可靠性研究  

RELIABILITY RESEARCH OF MULTI-PLANNAR REFORMATION OF MULTI-SPIRAL COMPUTERIZED TOMOGRAPHY IN MEASURING KYPHOSIS ANGLE AFTER THORACOLUMBAR FRACTURE

作　　者：林旭波[1] 陈久尊[1] 何家维[1] 程建敏[1] 严志汉[1] 贺辉[1] 

机构地区：[1]温州医学院附属第二医院放射科,浙江温州325027

出　　处：《中国修复重建外科杂志》2010年第5期531-534,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨通过多层螺旋CT(multi-spiralCT,MSCT)的多平面重组(multi-plannar reformation,MPR)图像测量胸腰段骨折后凸角的可行性和可靠性。方法选择2007年12月-2009年12月行胸腰段X线侧位片(CR片)和MSCT扫描检查且被诊断为胸腰段单个椎体骨折的45例患者。男32例,女13例;年龄24～63岁,平均48岁。致伤原因:交通事故伤25例,高处坠落伤12例,其他外伤8例。单纯压缩型骨折36个,爆裂型骨折9个。损伤部位:T116个,T1211个,L120个,L28个。伤后2h～7d行影像学检查22例,7d以上23例。由两位医师在CR片和MPR图像上测量后凸角,间隔3周后再重复测量1次,所得数据进行统计学分析。结果两位医师在CR片上测量后凸角平均分别为(20.75±8.31)°和(22.49±9.07)°,差异有统计学意义(P<0.05),相关性好(r=0.882,P<0.05);两位医师在MPR图像上测量后凸角平均分别为(16.65±8.62)°和(17.08±7.88)°,差异无统计学意义(P>0.05),相关性极佳(r=0.976,P<0.05)。在CR片和MPR图像上两位医师测量后凸角平均分别为(21.61±8.43)°和(16.87±8.20)°,差异有统计学意义(P<0.05),且相关性好(r=0.852,P<0.05)。结论在MSCT的MPR图像上测量胸腰段后凸角是可行的,且可靠性更好,但比在CR片上的测量值偏小。Objective To study the feasibility and reliability of the multi-plannar reformation （MPR） of multi-spiral CT （MSCT） in measuring the kyphosis angle （KA） after thoracolumbar fracture. Methods From December 2007 to December 2009,45 thoracolumbar fracture patients who underwent computed radiology （CR） and MSCT were recruited. There were 32 males and 13 females with a mean age of 48 years （range,24-63 years）,including 36 simple compression fractures and 9 burst fractures. The fracture locations were T11 in 6 cases ,T12 in 11 cases,L1 in 20 cases,and L2 in 8 cases. Fracture was caused by trafffic accident in 25 cases,by falling from height in 12 cases,and by others in 8 cases. The imaging examination was performed after 2 hours to 7 days of injury in 22 cases and after more than 7 days in 23 cases. The KA was measured on the lateral X-ray films of CR and MPR by two observers,then the measurements were done again after three weeks. The data were statistically analyzed. Results The average KA values on CR by two observers were （20.75 ± 8.31）° and （22.49 ± 9.07）°,respectively; showing significant difference （P 〈0.05）,and the correlation was good （r=0.882,P 〈0.05）. The average KA values on MPR by two observers were （16.65 ± 8.62）° and （17.08 ± 7.88）°,respectively,showing no significant difference （P〉 0.05）,the correlation was excellent （r=0.976,P 〈0.05）. The average KA values on CR and MPR were （21.61 ± 8.43）° and （16.87 ± 8.20）°,respectively; showing significant difference （P 〈0.05）,the correlation was good （r=0.852,P 0.05）. Conclusion It is more feasible and reliable in measuring the KA on MRP of MSCT than CR,but the value is larger on CR.

关 键 词：胸腰段骨折 后凸角 多层螺旋CT重建 X线片 

分 类 号：R683.2[医药卫生—骨科学] R814[医药卫生—外科学]