螺旋CT多平面和三维重建诊断腰椎小关节退变的对照研究  

Comparative study on spiral CT multi-planar and three-dimensional reconstruction in the diagnosis of lumbar facet joint degenerative injury

作　　者：吴世祥 张世科 郑业锟 WU Shi-xiang;ZHANG Shi-ke;ZHENG Ye-kun(Department of Radiology,the Sixth People's Hospital of Huizhou,Huizhou,Guangdong 516211,China)

机构地区：[1]惠州市第六人民医院放射科,广东惠州516211

出　　处：《颈腰痛杂志》2021年第2期177-180,184,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的对比分析螺旋CT多平面和三维重建在诊断腰椎小关节退变(facet joint degeneration,FJD)中的应用价值。方法回顾性分析2016年6月~2019年6月在本院收治的82例FJD患者,均经德国西门子64层螺旋CT平扫和增强扫描。扫描后采用原始图像后处理技术获得多平面重建和三维重建图像,对观察到的FJD进行CT分级和病理分级。采用Kappa一致性检验探讨多平面重建和三维重建对FJD分级的一致性。结果82例中,单节段FJD 61例,多节段FJD 21例,包含112个节段FJD。MSCT多平面重建检出FJD的检出率为83.93%,明显高于三维重建的75.89%;联合检测的检出率为91.07%,明显高于多平面重建或三维重建单独诊断。MSCT多平面重建检出FJD 1级、2级、3级、4级的Kappa值分别为0.493、0.554、0.659、0.711;MSCT三维重建检出FJD 1级、2级、3级、4级的Kappa值分别为0.641、0.648、0.741、0.768;联合诊断检出FJD的Kappa值分别为0.667、0.688、0.784、0.781。联合检测和MSCT三维重建检出FJD分级的Kappa值明显高于CT多平面重建。结论MSCT多平面重建技术联合三维重建对于FJD的检出和判定FJD分级具有较高的应用价值。Objective To compare and analyze the application value of spiral CT multi-planar and three-dimensional reconstruction in the diagnosis of lumbar facet joint degenerative(FJD)injury.Methods A retrospective analysis was performed in 82 FJD patients who admitted to the hospital from June 2016 to June 2019.All patients underwent plain scan and enhancement scan of German Siemens 64-slice spiral CT machine.After scanning,original image post-processing technique was applied to obtain multi-planar reconstruction(MPR)and three-dimensional reconstruction(TDR)images.CT grading and pathological grading were performed based on FJD.Kappa consistency test was applied to determine consistency between MPR and TDR for FJD injury classification.Results Of the 82 FJD patients,there were 61 cases with single-segment FJD,and 21 cases with multi-segment FJD,including 112 segmental lumbar FJD.The detection rate of MSCT MPR for FJD injury was significantly higher than that of TDR(83.93%vs 75.89%).The detection rate of combined detection(91.07%)was significantly higher than that of MPR or TDR alone.Kappa values of MSCT MPR for detecting FJD injury at grade 1,2,3 and 4 were 0.493,0.554,0.659 and 0.711,respectively.The above indicators of MSCT TDR were 0.641,0.648,0.741 and 0.768,respectively,and above indicators of combination detection were 0.667,0.688,0.784 and 0.781,respectively.Kappa values of combined detection and MSCT TDR for detecting FJD injury grading were significantly higher than those of CT MPR.Conclusion Combined with MSCT MPR and TDR technique has high application value for the detection of FJD lesions and FJD injury grading.

关 键 词：螺旋CT 多平面重建 三维重建 腰椎小关节退变 

分 类 号：R445[医药卫生—影像医学与核医学]