单能量去金属伪影技术在膝关节肿瘤假体置换术后随访中的临床价值  

Single energy metal artifact reduction technique in the evaluation of postoperative tumor endoprostheses in the knee joint

作　　者：丁磊[1] 张芳玲[1] 张朝晖[1] 高振华[1] 孟悛非[1] 马玲[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《中华放射学杂志》2017年第7期515-518,共4页Chinese Journal of Radiology

摘　　要：目的评估单能量去金属伪影技术（SEMAR）结合320层螺旋CT去除膝关节肿瘤假体伪影的效能。 方法回顾性分析2015年11月至2016年3月在我院随访的膝关节肿瘤假体置换术后患者23例，进行膝关节320层CT扫描获得其原始数据。分别用常规的迭代重组（IR）和IR结合SEMAR重组，得到相应的两组CT图像。在关节平面和截骨平面，对各ROI进行主、客观评价，并使用Wilcoxon秩和检验比较这两种重组方法的差异。 结果与IR相比，客观方面，SEMAR使得截骨平面ROI的伪影指数（AI）值降低了44.8%~74.1%，而关节平面的AI值降低了73.2%~93.2%；主观平面，SEMAR使得截骨平面的图像评分增加了0.5~2.0分，关节平面的评分增加了1.0~4.0分。SEMAR技术在主、客观评价时均显著地降低了膝关节肿瘤假体伪影对CT图像的影响，差异有统计学意义（P〈0.05）。 结论SEMAR技术能够减少膝关节肿瘤假体产生的伪影，提高对假体周围结构的辨识，尤其在关节平面其效果更显著。ObjectiveTo evaluate the effect of the single energy metal artifact reduction （SEMAR） algorithm with a 320 multi-slice computed tomography （MSCT） volume scanner in patients with knee tumor prostheses. MethodsFrom November 2015 to March 2016, 23 consecutive patients with knee tumor prostheses who underwent a 320-MSCT scan were collected. And the raw data were reconstructed using two different methods： conventional iterative reconstruction （IR） alone and IR associated with SEMAR. The ROI were objectively and subjectively assessed at osteotomy level and articular level, and the Wilcoxon signed rank test was used for them. ResultsCompared with IR, objectively, artifact index （AI） values of the osteotomy level decreased 44.8% to 74.1% and that of the articular level decreased 73.2% to 93.2%; subjectively, the scores of image quality of two levels were increased 0.5 to 2.0 scores and 1.0 to 4.0 scores by SEMAR respectively. The objective and subject image quality of periprosthetic structures were all significantly improved by the SEMAR algorithm （P〈0.05）. ConclusionThe SEMAR algorithm significantly reduced the metal artifact of knee tumor prostheses, improved the image quality of periprosthetic structures and may increase diagnostic confidence of prosthetic complications in patients with modular knee tumor prostheses, especially at the osteotomy level.

关 键 词：膝关节 人工 体层摄影术 X线计算机 

分 类 号：R730.44[医药卫生—肿瘤] R738[医药卫生—临床医学]