320排CT去金属伪影在评价腰椎内固定术后情况的临床价值  

The clinical value of 320-row CT metal artifact reduction in patients with postoperative lumbar fixation

作　　者：唐启瑛 阎作勤[2] 陆秀良[1] 孟文斌 侯凯[1] 周建军[1] 

机构地区：[1]复旦大学附属中山医院放射诊断科上海市影像医学研究所复旦大学上海医学院影像学系,上海200032 [2]复旦大学附属中山医院骨科 [3]东芝医疗系统有限公司上海分公司

出　　处：《实用放射学杂志》2015年第11期1824-1827,1835,共5页Journal of Practical Radiology

摘　　要：目的 探讨320排CT去金属伪影技术（SEMAR）对腰椎内固定术后患者的临床应用价值.方法 50例腰椎内固定术后患者,均行320排CT容积扫描,评价去伪影前后图像中软组织、硬膜囊、椎间盘、神经根、侧隐窝、金属与骨质的界面、椎弓根、椎体的显示情况,分别测量2组图像中金属伪影最严重处的CT值、周围软组织CT值以及椎弓根螺钉的直径,对所有评价及测量结果采用配对t检验进行比较,并分析其临床价值.结果 在软组织、硬膜囊、椎间盘、金属与骨质的界面、椎弓根及椎体方面,去伪影后的图像评分明显高于去伪影前,两者的差异有统计学意义（P＜0.05）,而在神经根、侧隐窝的显示上,两者的差异无统计学意义（P＞0.05）.去伪影后的CT值及周围软组织CT值均大于去伪影前,去伪影后测得的螺钉直径小于去伪影前,两者的差异均有统计学意义（P＜0.05）.去伪影前测得的螺钉直径与真实直径间的差值为（1.40±0.72） mm,差异有统计学意义（t=10.477,P=0.000）,而去伪影后测得的螺钉直径与真实直径间的差值为（0.14±0.75） mm,差异无统计学意义（t=1.046,P=0.305）.结论 SEMAR技术可以减轻金属伪影,有助于准确地观察椎弓根螺钉的位置及周围的组织结构,在腰椎内固定术后情况的评估中具有较大的应用价值.Objective To explore the clinical value of single-energy metal artifact reduction（SEMAR） of 320-row CT in patients with postoperative lumbar fixation. Methods Fifty patients after lumbar internal fixation underwent 320-row CT volume scan. Firstly, the image qualities o{ soft tissue, dural sac, disc, nerve root, lateral recess, the interface between metal and bone, pedicle, vertebral body were evaluated using a five-scale point. Secondly,the CT values were measured in both images before and after artifact reduction at the slice that showed the heaviest metal artlfacts,and the soft tissue around the screws was also measured. Finally, the diameters of pedicle screws were measured. For all the evaluation of the results,a paired t test was used for comparison,and the clinical value of SEMAR was analyzed. Results For soft tissue, dural sac, disc, metal and bone interface, pedicle and vertebral body, the scores in SEMAR were higher than that in the originai images, the difference between the two methods was statistically significant （P〈0.05）, while for the nerve root,lateral recess there was no statistically significant difference between the two methods （P〉0.05）. The CT values of both artifacts and soft tissue in SEMAR were higher than that in the original images, and the diameters of the pedicle screws in SEMAR were less than that in the the original images. The difference was statistically significant （P〈0.05）. The difference between the diameters measured before artifact reduction and the real diameters was （1.40±0. 72） mm, which was statistically significant （t= 10. 477, P= 0. 000）. The difference between the diameters measured after artifact reduction and the real diameters was （0.14 ±0.75） mm,which was not statistically significant （t= 1. 046, P= 0. 305）. Conclusion SEMAR technology can reduce metal artifacts, help to localise pedicle screws and observe the adjacent structures,which proves great value in the assessment of patients after lumbar internal fixation.

关 键 词：计算机体层成像 金属伪影 腰椎 

分 类 号：R814.42[医药卫生—影像医学与核医学] R687.3[医药卫生—放射医学]