CT感兴趣区体积法评估臀肌的可行性及临床应用  

The Feasibility and Clinical Application of CT Volume of Interest Method in Evaluating Gluteus Volume

作　　者：王凤仙 王冬梅[1] 常莹[1] 杨献峰[1,2] WANG Fengxian;WANG Dongmei;CHANG Ying;YANG Xianfeng(Department of Radiology,Nanjing Drum Tower Hospital,The filiatead Hospital of Nanjing University Medical School,Nanjing Jiangsu;Jiangsu Research Istitute of Sports Science)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,南京210008 [2]江苏省体育科学研究所

出　　处：《中国医学计算机成像杂志》2022年第6期627-634,共8页Chinese Computed Medical Imaging

基　　金：江苏省博士后科研资助计划(2021-188);上海市人类运动能力开发与保障重点实验室开放课题(2022-3)。

摘　　要：目的:探讨基于CT感兴趣区体积法测量臀肌体积及密度的可行性及临床意义。方法:回顾性搜集114例行128层CT扫描患者的临床及影像资料。根据Kellgren-Lawrence(K-L)评分对髋关节进行分级:K-L评分<2患者纳入A组(以45、65岁为界分为3个亚组:A1~3组);K-L评分≥2患者纳入B组;用分层比例抽样法从A组中抽取年龄、性别与B组匹配的47例患者纳入C组。所有患者由两名操作者分别在工作站使用感兴趣体积后处理软件进行臀肌范围勾画并三维重建,由软件自动测量两侧臀大、中、小肌的体积及CT值,1周后由一名操作者重复测量,应用相关系数评价观察者内及观察者间测量值的可靠性。比较臀肌体积和CT值的性别及左右侧差异,臀肌体积与年龄的关系,比较B、C两组患者臀肌体积和CT值的差异性。结果:臀肌体积及CT值测量的同一观察者及观察者间一致性良好。男性双侧臀大肌、右侧臀中肌、左侧臀小肌体积均显著大于女性,差异有统计学意义,男性患者左侧臀大肌CT值显著高于女性,差异有统计学意义;患者臀肌体积及CT值与患者年龄呈负相关,差异有统计学意义,K-L分级评分高者较评分低者臀肌体积更小,差异有统计学意义。结论:感兴趣区体积法可稳定、准确地用于评估臀肌体积与密度。臀肌体积萎缩与脂肪化程度与年龄相关,髋关节骨关节炎患者臀肌萎缩较无髋关节骨关节炎患者更显著。Purpose:To explore the feasibility and clinical significance of measuring the volume and density of gluteus based on CT area of interest.Methods:The clinical and imaging data of 114 patients who had undergone 128-slice CT scan were collected retrospectively.Hip joints were graded according to Kellgren-Lawrence(K-L)score.Patients with K-L score<2 were classified as group A,and patients with K-L score≥2 were classified as group B.Patients in group A were divided into three groups based on the age of 45 and 65.A stratified proportional sampling method was used to extract 47 patients from group A to group C,whose age and gender were matched with group B.The gluteal range of all patients was delineated by two individual operators using the volume of interest postprocessing software at the workstation.The software automatically measures the volume and the CT value of gluteus,and reconstructs three-dimensional images automatically.One radiologist repeated the measurements for interobserver agreement analysis a week after the first measurement.The intra-group correlation coefficient was used to evaluate the reliability of the measurement of intra-and interobserver.The difference of gluteus volume and CT value between gender,the difference between the left and right sides,the relationship between gluteus volume and age,and the difference of gluteus volume and CT value between group B and C were compared.Results:The gluteus muscle volume and CT values showed excellent intra-and interobserver agreement.The gluteal muscle volume and CT value demonstrated differences in gender and age.Gluteal volume and CT value were negatively correlated with age.The gluteal muscle volume and CT value of hip osteoarthritis patients were significantly smaller than those patients without hip osteoarthritis.Conclusions:The volume of interest method is stable and accurate in assessing the volume and density of the gluteal.The gluteal muscle volume atrophy and the degree of fat infiltration are related to age,and gluteal muscle atrophy is more

关 键 词：臀肌 体积测量 计算机体层成像 感兴趣区体积 髋骨关节炎 

分 类 号：R445.3[医药卫生—影像医学与核医学]