先天性半椎体畸形脊柱侧弯的不同体位影像检查结果差异研究  

Study on the differences of the results of image examination of different positions of patients with congenital hemivertebra deformity scoliosis on main curvature and segmental curvature

作　　者：刘嘉 李虹成 潘志华 沈鲲 肖科 涂波 LIU Jia;LI Hong-cheng;PAN Zhi-hua(Department of Radiology,The 2nd Affiliated Hospital of Chengdu Medical College,Nuclear Industry 416 Hospital,Chengdu 610051,China.)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院放射科,四川成都610051 [2]成都医学院第二附属医院·核工业四一六医院骨科,四川成都610051

出　　处：《中国医学装备》2023年第2期53-57,共5页China Medical Equipment

基　　金：四川省卫生健康委员会科研课题(17PJ197)“应用微应变传感器技术分析椎体成形术后邻近椎体生物力学变化”。

摘　　要：目的:探究先天性半椎体畸形脊柱侧弯主弯及节段弯应用不同体位影像检查应用价值。方法:选取医院收治的106例先天性半椎体畸形脊柱侧弯患者,均接受仰卧位磁共振成像(MRI)、站立位X射线和仰卧位CT检查,分析不同体位影像学检查在先天性半椎体畸形脊柱侧弯主弯及节段弯检查中的价值。结果:106例患者经X射线、CT及MRI检出脊柱异常分别为125处、186处及152处,3种检查方式对于分节不良、半椎体、肋骨畸形以及脊柱裂检出率比较,差异均有统计学意义(χ^(2)=14.955,χ^(2)=11.631,χ^(2)=9.725,χ^(2)=6.172;P<0.05),MRI对脊髓异常(脊髓纵裂、脊髓低位伴椎管内脂肪瘤及脊髓硬膜外脂肪瘤)检出率显著优于X射线与CT(χ^(2)=62.540,χ^(2)=19.670,χ^(2)=20.978;P<0.05)。3种检查方式对于主弯角度和冠状面平衡测定结果差异有统计学意义(F=9.179,F=539.564;P<0.05);其中,X射线测定主弯角度显著高于CT和MRI,冠状面平衡显著低于CT和MRI,差异均有统计学意义(t主弯角度=5.633,t=4.760;t冠状面平衡=39.878,t=40.579;P<0.05)。Pearson相关性分析显示,X射线与CT、MRI测定主弯角度均呈正相关(r=0.712,r=0.654;P<0.05);X射线、CT及MRI的3种检查方式获得的脊柱侧弯全貌、顶椎及脊髓畸形影像质量满意度比较,差异具有统计学意义(χ^(2)=81.019,χ^(2)=134.742,χ^(2)=99.366;P<0.05)。结论:站立位X射线与仰卧位CT可以有效检出先天性半椎体畸形,仰卧位MRI则可以有效发现脊髓异常,仰卧位CT与MRI可以有效评估脊柱侧弯主弯角度。Objective:To investigate the application value of imaging examinations of different positions of patients with congenital hemivertebra deformity scoliosis on main curvature and segmental curvature.Methods:106 patients with congenital hemivertebral deformity scoliosis who admitted to the hospital were selected,and all of them received magnetic resonance imaging (MRI) examination in the supine position,X-ray radiography in the standing position and computed tomography (CT) examination in the supine position.The values of imaging examinations of different positions on the main curvature and segmental curvature of patients with congenital hemivertebra deformity scoliosis were analyzed.Results:The X-ray,CT and MRI examinations respectively checked out 125,186 and 152 spinal abnormalities in 106 patients.The differences of the detection rates of unfavorable segmentation,hemivertebra and rib deformities and spina bifida among the 3 examination methods showed statistically significance (x~2=14.955,x~2=11.631,x~2=9.725,x~2=6.172,P<0.05).The detection rates of MRI for spinal cord abnormalities (diplomyelia,infraversion of spinal cord with lipomyoma of intraspinal and epidural lipomyoma of spinal cord) were significantly better than those of X-ray and CT (x~2=62.540,x~2=19.670,x~2=20.978,P<0.05),respectively.The differences of the measured results of three kinds of examination methods on main curvature angle and the balance of coronal plane were respectively significant (F=9.179,F=539.564,P<0.05).Among of them,the measured angle of main curvature of X-ray was significantly higher than that of CT and MRI,while the balance of coronal plane of X-ray was significant lower than that of CT and MRI (tthe angle of main curvature=5.633,t=4.760,tthe balance of coronal plane=39.878,t=40.579,P<0.05),respectively.Pearson correlation analysis showed that there were positive correlations between X-ray and CT,and between X-ray and MRI in measured the angle of main curvature (r=0.712,r=0.654,P<0.05),respectively.The differences of the satis

关 键 词：先天性半椎体畸形 脊柱侧弯主弯及节段弯 不同体位 影像检查方法 

分 类 号：R816.8[医药卫生—放射医学]