螺旋CT容积再现技术在脊髓纵裂合并骨嵴手术前后对比中的应用  

The application of volume rendering technique using spiral CT in the radiological research of the pre-postoperative intraspinal osseous septum

作　　者：郑冬[1] 刘文鹏[2] 张朝利[1] 赵亮[1] 闫如意 刘军华[1] 费军[1] 

机构地区：[1]中国人民解放军第306医院医学影像科,北京100101 [2]中国人民解放军第306医院神经外科,北京100101

出　　处：《医学影像学杂志》2014年第1期119-122,128,共5页Journal of Medical Imaging

摘　　要：目的清晰显示骨嵴切除术前、后椎管内骨嵴的三维立体结构,探讨螺旋CT容积再现技术的应用价值。方法44例脊髓纵裂并骨嵴患者骨嵴切除术前及术后均行全脊柱螺旋CT容积扫描,并行原始数据减薄容积再现技术(volume rendering technique,VRT)重建,观察骨嵴的三维立体形态,测量术前及术后骨嵴的前后径计算骨嵴残留率,并记录术中出血量。结果骨嵴可分为分叉型、不分叉连贯型、不分叉中断型,三者在骨嵴术后残留率及术中出血量方面差异均有统计学意义(P<0.05),其中分叉型骨嵴的术后残留率最高,术中出血量最多。结论 VRT图像可清晰显示骨嵴切除术前、术后椎管内骨嵴的三维立体形态,对手术效果的评判,根据骨嵴形态进行术前评估中具有重要的应用价值。并提示术前一定要注意骨嵴的分叉情况。Objective To clearly display the three dimensional morphology of the intraspinal osseous septum preopera tively and postoperatively and to discuss the clinical value of volume rendering technique. Methods Threedimensional re construction of 44 intraspinal osseous septa with volume rendering technique on the workstation of spiral CT was conduc ted preoperatively and postoperatively. The diameters of the osseous septa were measured on sagittal view respectively in order to determine their residual rate. Meanwhile, the amount of hemorrhage in operation was recorded. Results The os seous septa were classified into three types as bifurcation, coherent no bifurcation and incoherent no bifurcation. Compared with other types, the residual rate and hemorrhage volume of bifurcation septa were the highest. And these differences were statistically significant （ P 〈0.05）. Conclusion The three dimensional morphology of intraspinal osseous septum before and post resection could be clearly displayed on 3D images. It has an important practical value in diagnosis and pre operative evaluation of split cord malformation with intraspinal osseous septum. It is recommended to pay attention to the bifurcation of osseous septum.

关 键 词：脊髓纵裂 骨嵴 体层摄影术 X线计算机 三维重建 

分 类 号：R651.2[医药卫生—外科学]