CT三维重建在检测儿童脊柱侧弯生长棒矫治调控现象中的影像学价值研究  

The Imaging Value of Three-dimensional CT Reconstruction in Detecting the Correction of Scoliosis Growing Rod in Growing Children

作　　者：王贵生[1] 赵国全 刘昊[1] 吕志强 王倜 陈晓霞 WANG Gui-sheng, ZHAO Guo-quan, LIU Hao, LV Zhi-qiang, WANG Ti, CHEN Xiao-xia.(Radiology Department of The General Hospital of the Chinese people＇s Armed Police Force ,Beijing, 10003)

机构地区：[1]中国人民武装警察部队总医院CT科,北京100039 [2]中国人民武装警察部队急诊科

出　　处：《中国急救复苏与灾害医学杂志》2018年第5期458-462,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：首都临床特色应用研究项目（Z151100004015148）;中国人民武装警察部队总医院院级课题（WZ2015018）;中国人民武装警察部队总医院院级课题（WZ2017011）

摘　　要：目的通过脊柱CT三维重建方法对脊柱侧弯顶锥区域椎间隙进行观察，摸索建立一个客观、无创的观测脊柱侧弯患者行板-棍系统（plate—rodsy stem for scoliosis，PRSS）植入术后对于脊柱生长调控现象的指征。方法对2000年2月-2012年4月在北京协和医学院及中国人民武装警察部队总医院植入脊柱侧弯PRSS系统超过5年且现年龄≥10岁的儿童脊柱侧弯患者进行全脊柱CT扫描，对扫描结果进行三维重建，通过旋转图像观察顶锥区域终板软骨成熟、钙化、融合情况，评价PRSS的调控效果。同时计算有效辐射剂量（effective dose，ED）。结果15例PRSS术后的脊柱侧弯患者，平均年龄16．75岁，手术时平均年龄8．17岁，检查时间平均为术后8．58年。全脊柱CT扫描平均ED为（6．97±2．31）mSv，为安全范围。经三维重建后，观察顶锥区域融合情况，观察到10例患者脊柱侧弯凸侧终板软骨提前成熟、钙化，凸侧柞间隙较早出现融合，且随年龄增加逐渐明显，其中凹侧未融合者8例，凹侧融合者2例；无单纯凹侧融合者。结论运用CT扫描后三维重建方法，能够直观地观察到生长中的脊柱侧弯受调控后的生长成熟情况，是检测儿童脊柱侧弯生长棒矫治调控现象的可靠检测方法，且对于生长棒的手术取棒时机选择有一定的指导意义。Objective To observe the intelwertebral space atcurve apex by CT three-dimensional reconstruction of spine and explore an objective and non-invasive observation of plate-rod system for seoliosis （PRSS） implantation in patients with seoliosis Postoperative spine growth and regulation of the phenomenon. Methods Total spine CT scans were performed in children with scoliosis who were implanted in the PRSS system of scoliosis for more than 5 years and were now over 10 years old. The scan results were reconstructed in three dimensions. The end-plate cartilage in the vertex cones was observed by rotating the image, Calcification, fusion, evaluation of PRSS regulatory effect; at the same time calculate the effective dose （effective dose, ED）. Results The average age of 15 patients with scoliosis after PRSS was 16.75 years old. The average age of the patients was 8.17 years old. The average examination time was 8.58 years. The mean effective radiation dose （ED） of whole-spine CT scanning was 6.97 ± 2.31mSv, which was the safe range. After three-dimensional reconstruction, the top cone area fusion was observed. Ten cases of sciatic calcification showed that the cartilage in the scoliosis flexed earlier, the calcification and the convex intervertebral space merged earlier, and gradually increased with age, in which concave side Fusion in 8 cases, concave side of the fusion in 2 cases; no simple concave side fusion. Conclusion Three-dimensional CT reconstruction method can intuitively observe the growth and maturation of scoliosis in growth. It is a reliable method to detect the regulation of scoliosis growth rod in children. The timing of surgery to take the stick have a certain guiding significance.

关 键 词：CT扫描 三维重建 生长棒 脊柱侧弯板-棍系统 

分 类 号：R445[医药卫生—影像医学与核医学]