多排螺旋CT在胸腰椎椎弓根钉棒系统内固定金属断裂的诊断价值  

Diagnostic Value of Multi-Slice CT in Breakage of Posterior Thoracolumbar Screw-Rod System

作　　者：岑黄 崔运能[3] 黄武斌[3] CEN Huang;CUI Yun-neng;HUANG Wu-bin(Department of Radiology,the Third Affiliated Hospital of Southern Medical University;Academy of Orthopedics of Guangdong Province,Guangzhou 510630,China;Departmentof Radiology,Foshan Maternity and Children’s Healthcare Hospital,FoShan 528000,China)

机构地区：[1]南方医科大学第三附属医院影像中心 [2]广东骨科研究院,广州510630 [3]佛山市妇幼保健院放射科,广东佛山528000

出　　处：《南昌大学学报（医学版）》2019年第2期45-48,I0001,共5页Journal of Nanchang University：Medical Sciences

基　　金：广东省科技计划项目基金资助项目(2014A020212496)

摘　　要：目的探讨多排螺旋CT在胸腰椎椎弓根钉棒系统内固定金属断裂的诊断价值。方法收集2013年1月至2017年12月经手术确诊的胸腰椎椎弓根钉棒系统内固定金属断裂的患者,共19例。患者均行多排螺旋CT检查获得薄层轴位图像,再行多平面重建(MPR)处理获得轴位、矢状位、冠状位图像,并利用表面遮盖(SSD)、容积再现(VR)技术进行三维重建。由两名经验丰富的放射科医师在图像储存与传输系统(PACS)共同阅读CT图像,对比各组图像对内固定金属断裂的显示效果。结果19例患者,可见22枚螺钉、3条钛棒断裂。其中VR对螺钉及钛棒断裂效果均较好;矢状位图像对螺钉断裂显示效果次之,轴位图像再次,SSD及冠状位图像难以显示螺钉断裂;矢状位及冠状位图像对钛棒断裂显示较好,SSD次之,轴位图像难以显示钛棒断裂。结论多排螺旋CT检查可清晰显示胸腰椎椎弓根钉棒系统内固定金属断裂,其中VR图像对内固定金属断裂显示效果最佳,矢状位重建图像也可显示大部分螺钉及钛棒断裂。Objective To explore the diagnostic value of multi-slice spiral CT(MSCT) in the breakage of posterior thoracolumbar screw-rod system. Methods Nineteen patients suffering from surgically confirmed breakage of posterior thoracolumbar screw-rod system between January 2013 and December 2017 were enrolled in this study.The MSCT was conducted to obtain the thin-sliced axial images.The multiple planar reconstruction(MPR) was performed to produce the axial,sagittal and coronal images.In addition,three-dimensional reconstructions were carried out with surface shadow display(SSD) and volume rendering(VR).Two experienced radiologists read the CT images in PACS stations to assess the diagnostic effects of different groups of images on breakage of screw-rod system. Results Twenty-two screws and 3 titanium rods broke in the 19 patients.The VR had the optimal efficacy for showing the breakage of both screws and titanium rods.The breakage of screws was well shown on sagittal images,followed by axial images.The SSD and coronal images couldn’t display the breakage.The breakage of titanium rods was well displayed on sagittal and coronal images,followed by SSD.The axial images couldn’t display the breakage. Conclusion The MSCT can clearly illustrate the breakage of posterior thoracolumbar screw-rod system.The VR provides the best display quality,and the sagittal images show most of the breakage of screws and titanium rods.

关 键 词：多排螺旋CT 椎弓根钉棒系统 胸腰椎 内固定 螺钉断裂 钛棒断裂 VR图像 矢状位重建图像 

分 类 号：R687.32[医药卫生—骨科学] R814.42[医药卫生—外科学]