低剂量螺旋CT三维重建在骨骺损伤早期诊断中的临床价值探讨  

The study on clinical value of dimensional reconstruction of Low-dose Multislice CT to the early diagnosis on epiphyseal injuries

作　　者：沈濬[1] 周斌 张爱国[1] 蒋兆贯[3] 廖家新[4] 徐大鹏[1] 毛永敏 王武愉[1] 

机构地区：[1]南京医科大学附属无锡市人民医院无锡市儿童医院骨科,江苏省无锡市214023 [2]苏州市相城区中医院骨伤科,江苏省苏州市215100 [3]南京中医药大学附属无锡市中医医院放射科,江苏省无锡市214071 [4]南京中医药大学附属无锡市中医医院骨伤科,江苏省无锡市214071

出　　处：《临床小儿外科杂志》2015年第1期37-41,共5页Journal of Clinical Pediatric Surgery

基　　金：2009年江苏省无锡市科技局指导性计划CSZ00943

摘　　要：目的 研究低剂量螺旋CT三维重建在骨骺损伤中的成像质量及其对临床治疗的价值。方法 随机选择16岁以下儿童骨骺损伤病例30例作为实验组，早期选择普通X线摄片和低剂量螺旋CT三维重建，根据低剂量螺旋CT三维重建确定骨骺损伤类型，指导临床治疗，随访2年，对疗效进行评估，选择经常规剂量CT检查患儿30例作为对照组，对两组CTDIvol值、DLP值、图像噪声、及图像质量评分均值，用t检验进行比较。结果 通过30例患儿随访2年观察考核指标，两组CTDIvol值分别为（9．6）和（2．4）mGy，DLP值分别为（156．60±4．30）和（25．40±7．99）mGy．cm，低剂量组较常规组下降约61．68％，两者差异有统计学意义（P〈0．05），低剂量组噪声均值略高于常规组（分别为11．36±2．95和16．42±2．96），t=-7．199，P=0．000，但两组图像质量平均评分分别为（4．85±0．41）分和（4．81±0．44）分，差异无统计学意义（t=0．465，P〉0．05）。结论 低剂量螺旋CT三维重建技术可降低辐射剂量，且所得图像质量不影响诊断，可对骨骺损伤准确诊断，具有较高的临床价值。Objective To explore the image quality and clinical value of dimensional reconstruction of Low-dose Multislice CT. Methods 30 cases of children with epiphyseal injuries who were under 16 years old randomly were selected as the experimental group. The group of X-ray radiography and dimensional reconstruction of Low-dose Multislice CT were choosed respectivly to determine the type Of epiphyseal injuries and take appropriate therapeutic measures. The efficacy of this treatment with 2-year follow-up was evaluated. 30 children with epiphyseal injuries who were evaluated by the conventional dose CT examination were selected as a control group. With images ＂quality score including CTDIvol, DLP being double-blinded, the image noise and quality score of the images were anlysed by t-test to assess its clinical value. Results The CTDIvol of two groups were （ 9.6 ） and （2.4） mGy, DLP were （ 156.60 ± 4.30） and （ 25.40 ± 7.99 ） mGy. cm. Group of low-dose declined about 61.68% compares with group of conventional-dose. Difference between two groups showed statistically significant（ P 〈 0.05 ）. The average of noise was higher in group of low-dose compared with group of conventional-dose （each was 11.36 ± 2.95 and 16.42± 2.96） , t = - 7. 199, P = 0,000. But the mean image quality score[ （4.85 ± 0. 41 ） points and （4.81 ± 0. 44） points], have no statistically significant difference （ t = 0. 465, P 〉 0.05 ）. From these appraisal indexes, we improved that dimensional reconstruction of Low-dose Multisliec CT can parting epiphyseal injury precisely, also assist clinical diagnosis and treatment effectively,and the result was satisfaetory. Conclusion Dimensional reconstruetion of Low-dose Multislice CT can reduce dose without influence diagnostics, It can dignose epiphyseal injuries correctly and have a high clinical value.

关 键 词：体层摄影术 螺旋计算机 骨骺/损伤 早期诊断 

分 类 号：R726.8[医药卫生—儿科]