低剂量CT扫描容积再现技术评估儿童骺板骨桥的研究  

Study of low-dose CT scan volume rendering technology in evaluating the physeal bar in children

作　　者：邓书贞[1] 罗嗣频 付喆[1] 王侃[1] 陈兆强[1] 杨建平[1] 胡永成[3] 张中礼[1] Deng Shuzhen;Luo Sipin;Fu Zhe;Wang Kan;Chen Zhaoqiang;Yang Jianping;Hu Yongcheng;Zhang Zhongli(Deparment of Pediatric Orthopeadics,Tianjin Hospital,Tianjin 300211,China;Department of First Radiology,Tianjin Hoapital,ianjin 300211,China;Department of Bone and Soft Tissue Oncology,Tianjin Hoapital,Tianjin 300211,China)

机构地区：[1]天津市天津医院小儿骨科,天津300211 [2]天津市天津医院放射一科,天津300211 [3]天津市天津医院骨与软组织肿瘤科,天津300211

出　　处：《中华骨科杂志》2022年第8期492-499,共8页Chinese Journal of Orthopaedics

基　　金：天津市卫生健康委员会科技人才培养项目(ZC20211)。

摘　　要：目的通过低剂量CT扫描容积再现(volume rendering,VR)技术评估骺板骨桥,并以传统曲面重建(curved planar reconstruction,CPR)技术作为对照,验证其可行性。方法回顾性分析2019年1月至2021年12月治疗的20例骺板骨桥患儿术前CT扫描资料,其中男13例,女7例,年龄(9.94±2.91)岁。病因包括创伤17例,肿瘤1例,原因不明2例。受累部位包括股骨远端9例,胫骨近端5例,胫骨远端3例,桡骨远端3例。均利用VR技术对骺板骨桥进行评估,观察指标包括:骨桥比例,即骨桥占全部骺板的大小;骨桥类型,即骨桥于骺板内的形态。评估方法为:比较VR技术的组间及组内一致性;与传统CPR技术的评估结果进行对比研究;与既往文献测量结果进行比较,综合分析验证VR技术的可行性。结果所有患儿均一次扫描成功,无一例需要药物镇定,曝光时间(3.81±0.83)s,扫描时仅对受累部位关节进行低剂量扫描,并进行常规放射保护。利用VR技术评估骨桥比例,3名测试者结果分别为25.36%±15.36%,24.75%±16.18%,26.70%±17.72%,组间一致性程度很强(ICC=0.976);同一测试者3次重复测量结果为25.36%±15.36%,25.41%±15.20%,25.74%±16.00%,组内一致性程度很强(ICC=0.990)。与传统CPR技术评估进行对比,3名测试者得到结果分别为28.36%±16.74%,23.66%±19.87%,35.25%±15.92%,组间一致性程度较强(ICC=0.737);同一测试者3次重复测量结果分别为28.36%±16.74%,31.66%±13.06%,30.89%±12.52%,组内一致性程度很强(ICC=0.875)。但VR技术组间及组内ICC相关系数值均优于CRP技术。对3名测试者测量结果及同一测试者3次重复测量结果进行配对t检验,差异均有统计学意义(P<0.05)。利用VR技术评估骨桥类型,3名测试者判断20例患儿骨桥类型结果均一致;而3名测试者利用CPR技术评估时18例结果一致,2例存在差异,证实VR技术组间一致性更高。结论低剂量CT扫描容积再现技术是一种有效的评估儿童骺板骨桥的方法,�Objective To evaluate the feasibility of CT volume rendering technology in the assessment of the physeal bar in children.Methods A retrospective analysis of the relevant CT data of 20 patients with physeal bar from January 2019 to December 2021,13 boys and 7 girls,age 9.94±2.91 years.The etiology included 17 cases of trauma,1 cases of tumor,and 2 cases of unknown.The affected sites included 9 cases of distal femur,5 cases of proximal tibia,3 cases of distal tibia,and 3 cases of distal radius.Evaluate using volume rendering technology and traditional surface reconstruction technology respectively and the index include the size and type of physeal bar.Results All the children were successfully examined at one time,and none of them required sedation.The average exposure time was 3.81±0.83 s.During scanning,only low-dose radiation was performed on the affected joints,and routine radiation protection was performed.Using volume rendering technology to evaluate the proportion of the physeal bar,the results obtained by the three testers were 25.36%±15.36%,24.75%±16.18%,26.70%±17.72%,and the intraclass correlation coefficient value(ICC)was 0.976,the three repeated measurements by one tester were 25.36%±15.36%,25.41%±15.20%,25.74%±16.00%(ICC=0.990).Compared with the traditional curved planar reconstruction technical evaluation,the results obtained by the three testers were 28.36%±16.74%,23.66%±19.87%,35.25%±15.92%(ICC=0.737),the three repeated measurement results by one tester were 28.36%±16.74%,31.66%±13.06%,30.89%±12.52%(ICC=0.875).The volume rendering technology was better than the curved planar reconstruction technique.Paired t test was performed on the measurement results of three evaluators and the three repeated measurements of the same evaluator,and the differences were statistically significant(P<0.05).The same results were acquired by using volume rendering technology to evaluate the type of phseal bar with three testers;but there were 18 cases had the same results by using curved planar reconstruct

关 键 词：生长面 儿童 锥束计算机体层摄影术 肌肉骨骼畸形 

分 类 号：R726.8[医药卫生—儿科]