X线数字断层融合技术在寰枢椎脱位检查中的应用  

The application of X-ray digital tomosynthesis for atlantoaxial dislocation diagnosis

作　　者：汤永刚 杨斌[1] 张良[1] 靳晓晖 张帅[1] 贾阳 TANG Yonggang;YANG Bin;ZHANG Liang;JIN Xiaohui;ZHANG Shuai;JIA Yang(Department of Radiology, Hong Hui Hospital, Xian Jiaotong University, Xian 710054, China;School of Computer, Xi'an University of Posts and Telecommunications, Xi'an 710121, China;Shanxi Key Laboratory of Network Data Intelligent Processing, Xian University of Posts and Telecommunications, Xian 710121, China)

机构地区：[1]西安交通大学附属红会医院放射科,陕西西安710054 [2]西安邮电大学计算机学院,陕西西安710121 [3]西安邮电大学,陕西省网络数据智能处理重点实验室,陕西西安710121

出　　处：《医学影像学杂志》2022年第5期827-830,共4页Journal of Medical Imaging

基　　金：陕西省教育厅科学研究计划项目(编号:18JK0722);陕西省重点研发计划项目(编号:2019GY-021)。

摘　　要：目的探讨X线数字化断层融合成像技术(digital tomosynthesis,DTS)对寰枢椎脱位的诊断价值。方法选取我院2018年1月~2020年7月期间共113例寰枢椎脱位患者的影像资料,其中包括DR检查43例,DTS检查17例,CT检查63例。并对其行影像诊断符合率和有效剂量(effectivedose,ED)换算值的对比分析。结果DR检查中诊断寰枢椎脱位20例,占46.50%,DTS检查诊断寰枢椎脱位15例,占88.20%,CT检查诊断寰枢椎脱位60例,占95.20%。DTS和CT诊断寰枢椎脱位的符合率均明显高于DR,差异有统计学意义(P<0.05)。DTS和CT诊断寰枢椎脱位的符合率差异无统计学意义(P>0.05)。寰枢椎检查在DR正位、侧位,DTS冠状位、矢状位和CT的ED分别为(0.0961±0.0469)mSv、(0.0974±0.0471)mSv、(0.1358±0.0117)mSv、(0.1135±0.0132)mSv、(0.8377±0.0769)mSv。DTS和CT的有效剂量明显高于DR,CT的有效剂量明显高于DTS。结论DTS成像技术对寰枢椎脱位的诊断符合率高于常规DR,接近CT,但其辐射剂量远低于CT。因此,提倡DTS作为临床寰枢椎脱位诊疗的重要检查方法。Objective To explore the application value of X-ray digital tomographic fusion imaging technology in the examination of atlantoaxial dislocation.Methods The imaging data of 113 patients with atlantoaxial dislocation admitted to our hospital from January 2018 to July 2020 were collected.Among them,43 cases underwent DR imaging,17 DTS examinations,and CT examinations 63 cases.For these examinations,a comparative analysis of the coincidence rate of imaging diagnosis and the conversion value of effective dose was performed.Results DR diagnosed 20 cases of atlantoaxial dislocation,accounting for 46.50%,DTS diagnosed 15 cases of atlantoaxial dislocation,accounting for 88.20%,and CT diagnosed 60 cases of atlantoaxial dislocation,accounting for 95.20%.The diagnostic coincidence rate of atlantoaxial dislocation by DTS and CT was significantly higher than that of DR,and the difference was statistically significant(P<0.05).There was no significant difference in the diagnostic coincidence rate between DTS and CT examination(P>0.05).The ED of the atlantoaxial DR in the anteroposterior,lateral,DTS,and CT coronal and sagittal positions were(0.0961±0.0469)mSv,(0.0974±0.0471)mSv,(0.1358±0.0117)mSv,(0.1135±0.0132)mSv,(0.8377±0.0769)mSv,respectively.The effective dose of DTS and CT was significantly higher than that of DR,and the effective dose of CT was significantly higher than that of DTS.Conclusion The diagnostic coincidence rate of DTS imaging for the diagnosis of atlantoaxial dislocation is higher than that of conventional DR,close to CT,and has obvious advantages over DR.The radiation dose is much lower than CT.DTS can be used as the main method of diagnosis and treatment of atlantoaxial dislocation.

关 键 词：X线数字断层融合成像技术 寰枢关节脱位 影像诊断符合率 空间分辨率 有效剂量 

分 类 号：R681.5[医药卫生—骨科学] R445[医药卫生—外科学]