16-MSCT在特发性脊柱侧凸三维矫形术前的临床应用  

The Preoperative Clinical Application of 16-MSCT in Idiopathic Scoliosis

作　　者：柴军[1] 王淑清[2] 陈亮[2] 秦冬雪[2] 朱万安 王静[2] 

机构地区：[1]内蒙古自治区医院放射科,内蒙古010017 [2]吉林大学第一医院放射科,吉林130021

出　　处：《当代医学》2010年第11期194-197,共4页Contemporary Medicine

摘　　要：目的探讨16-MSCT对特发性脊柱侧凸三维矫形术前的临床应用价值。材料与方法经临床确诊并行三维矫形术的特发性脊柱侧凸患者10例,男性1、女性9,年龄11～15岁,其中1例行术后CT复查。使用GE公司的lightspeed-16CT机,采用螺旋扫描模式,对特发性脊柱侧凸患者进行胸段脊柱扫描,层厚:1.25mm/16i,电压:120KV,电流:140MAs;重建模式:标准重建。所得数据传至AW4.1工作站进行后处理,包括VR,MPR重组。分别在凸凹侧椎弓根截面积最大层面的图像上测量各自椎弓根两侧骨皮质内缘间及外缘间的最小距离即椎弓根宽度、椎弓根长度、椎弓根轴线分别与椎体前缘交点和椎板后缘交点之间的距离即椎弓根深度,椎弓根轴线与椎体中线间的夹角即横断面角。在垂直于椎弓根轴线的"二次扫描线"重组图像上,选择椎弓根截面积最小的图像,分别测量凸、凹侧椎弓根的高度。结果5例特发性脊柱侧凸患者使用16层螺旋CT扫描胸段脊柱均获得满意的原始图像和重建图像,所有病变脊柱胸段椎弓根均精确测到了具有临床意义的参数。应用这些参数,其中1例术后复查患者取得满意的手术治疗效果;提高了术前评估的充分性;而且明显简化和优化了术前评价方法。结论16层螺旋CT对特发性脊柱侧凸畸形三维矫形术的术前评估有十分重要的价值。可以为临床提供更多有用的信息,直接指导手术治疗。Objective To evaluate the efficiency of the preoperative clinical application of 16-MSCT in idiopathic scoliosis. Methods A GE Lightspeed-16 CT was used to scan the whole spine of 10 patients of idiopathic scoliosis,1 male,9 female,aged between 13 and 15. 2 of them were counterchecked post operation. Helix scanning mode was used. Slice thickness： 1.25mm/16i. Voltage： 120kv. Current： 139mA. Reconstructive mode： standard. Scanning data were transferred into AW4.1 workstation,VR,MPR,MPCR and Spine Vessel were used to reconstruct the vertebral column. The images with the largest cross section area of pedicle on the concave and convex side were chosen respectively. the transverse endosteal width and the transverse periosteum width of pedicles; and measure the distance between pedicle axes and the point of intersection to the anterior border of vertebral body,as well as the distance between pedicle axes and the point of intersection to the posterior border of vertebral lamina; the included angle between pedicle axes and midline of vertebral body,the transverse pedicle angle also should be measured. In the secondary scanning reconstruction images which are perpendicular to the pedicle axes,choose the image with the least cross section area of the pedicles,then measure the height of pedicles on the concave and convex sides. Result all cases achieved approving original and reconstructed images,as well as measurement of thoracic pedicles involved. One case that called back after operation achieved satisfactory effect using those information,in this way,we can simplify and optimize the methods of evaluation preoperation. Conclusion 16 multislice spiral CT is effective to preoperative evaluate of three-dimensional orthopedic operation to idiopathic scoliosis,it can offer more valuable information to the clinic,consequently direct the operation project.

关 键 词：特发性脊柱侧凸畸形 临床应用价值 三维矫形术 术前评估 16层螺旋CT 重组图像 螺旋CT扫描 椎弓根 

分 类 号：R687.3[医药卫生—骨科学]