多层螺旋CT三维重建在Chiari I型畸形骨性后颅窝测量中的应用  

Multislice spiral CT three-dimensional reconstruction of the posterior cranial fossa in Chiari I malformation

作　　者：田超[1] 阎世鑫[1] 靳松[1] 谢中福[1] 

机构地区：[1]天津市环湖医院CT室,天津300060

出　　处：《实用放射学杂志》2011年第12期1811-1815,共5页Journal of Practical Radiology

摘　　要：目的 评价多层螺旋CT（MSCT）三维重建诊断Chiari I型畸形患者骨性后颅窝发育不全的临床意义.方法 以52例Chiari I型畸形患者骨性后颅窝为研究对象并以100例正常成人后颅窝为参照.测量项目包括：后颅窝前后径（TL）、后颅窝高度（PCFH）、枕大孔前后径（FMD）、斜坡长度（CL）、后枕长度（SL）、小脑幕倾斜角（ACTS）和后颅窝容积（PCFV）.采用独立样本资料t检验比较Chiari I型畸形组及对照组后颅窝形态测量结果的差异,计算Pearson相关系数（r）评价TL、PCFH、FMD、CL、SL和ACTS与PCFV间的相关性.结果 与对照组比较,Chiari I型畸形组的TL、CL、PCFH和PCFV减小而FMD和ACTS增加,差异有统计学意义,SL虽然减小但差异无统计学意义.PCFH、CL和SL与PCFV呈正性相关,FMD和ACTS与PCFV呈负性相关,其中PCFH（r=0.813,P〈0.001）和CL（r=0.752,P〈0.001）与PCFV的相关性较高.Chiari I型畸形组与对照组各测量结果间的95%置信区间均无重叠.结论 MSCT三维重建技术能够对骨性后颅窝形态进行准确测量,可以作为评价骨性后颅窝发育不全的影像学方法之一.MSCT的测量结果可以进一步完善对Chiari I型畸形患者后颅窝狭窄的诊断.Objective To assess the clinical usefulness of MSCT three-dimensional reconstruction in diagnosis of osseous posterior cranial fossa（PCF）hypoplasia in patients with Chiari I malformation. Methods Osseous PCF of 52 adult patients with Chiari I real formation and 100 healthy adults control subjects involved in this study. Variable measurements includeing Twining＇s line （TI.）, foramen magnum diameter （FMI））, posterior cranial fossa height （PCFH）, clivus length （CL）, supraoceiput length （SL） , angle of cerebellar tentorium steepness （ACTS） and posterior cranial fossa volume （PFCV）. Independent sample Student＇s t test was used as a statistical method. Pearson correlation coefficient （r） was calculated to summarize the relationship between parameters and volume of PCFV. Results The mean of TL, CI., PCFH and PCFV reduced and the mean of FMD and ACTS increased with statistically sig nificant difference in Chiari I malformation group compared to that in control group. The mean of SI. reduced with no statistically significant difference. There was significant positive correlation between PCFH, CI., SI., and PCFV, and there was significant negative correlation be tween FMD, ACTS, and PCFV. The correlation coefficient of PCFH （r= 0. 813, P〈0. 001） and CI. （r-0. 752, P〈0. 001 ） were much higher than that of the others. The 95 % confidential interval of Cbiari I malformation group and control were not showed any overlapping in all the parameters. Conclusion MSCT three-dimensional reconstruction is an efficient and accurate method for osseous PCF measure ment, and is able to be one of the radiological diagnostic modality in assessing overcrowding of PCF.

关 键 词：颅骨 CHIARI I 畸形 体层摄影术 X线计算机 

分 类 号：R651[医药卫生—外科学] R814.42[医药卫生—临床医学]