不同影像学检查方法在脊柱侧弯术前评估中的应用研究  

Comparative study of different imaging methods in preoperative evaluation of scoliosis

作　　者：侯金丹 茅国群[2] 熊星 徐文杰 徐建昌 HOU Jindan;MAO Guoqun;XIONG Xing(Jiangnan Hospital of Zhejiang Chinese Medical University of Traditional ChineseMedicine,Zhejiang 311200,China)

机构地区：[1]浙江中医药大学附属江南医院,杭州311200 [2]浙江省立同德医院 [3]浙江中医药大学

出　　处：《浙江创伤外科》2023年第4期617-622,共6页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨不同影像学检查方法在脊柱侧弯患者术前评估中的应用价值。方法回顾性分析80例浙江中医药大学附属江南医院经手术治疗的脊柱侧弯患者,所有患者均行脊柱全长正侧位DR摄片、CT和MRI检查。分析三种方法对脊柱侧弯患者椎体畸形、髓内病变检出率及Cobb角评估的差异性,并评价其临床应用价值。结果DR、CT、MRI分别检出椎体发育异常13例、23例、14例,DR和MRI与CT对椎体发育异常的检出率比较差异有统计学意义(P<0.05)。CT显示脊柱侧弯全貌80例、顶椎80例、脊髓病变1例;MRI显示脊柱侧弯全貌29例、顶椎40例、脊髓病变9例,CT和MRI检出率比较差异均有统计学意义(P<0.05)。DR和CT测量脊柱侧弯主弯Cobb角分别为(71.10±36.94)°、(59.53±36.30)°,两者比较差异有统计学意义(P<0.05);但对较大Cobb角(≥80°)测量比较差异无统计学意义(P>0.05)。结论DR、CT、MRI在脊柱侧弯患者术前评估中各有优缺点,对于需要手术矫正的患者,X线和CT应作为常规的检查项目,当患者有神经症状或临床怀疑有脊髓病变或先天性脊柱侧弯时推荐MRI检查。Objective To investigate the application value of different imaging methods in preoperative evaluation of scoliosis.Methods 80 patients with scoliosis who underwent surgery in our hospital were retrospective analyzed.All patients underwent full-length anteroposterior and lateral DR radiography,CT and MRI examination.To analyze the differences in the detection rates of vertebral deformity,intramedullary lesions and Cobb Angle of the three methods in patients with scoliosis,and to evaluate the differences in clinical application value.Results There were 13 cases of vertebral dysplasia detected by DR,23 cases detected by CT,and 14 cases detected by MRI.There was a statistically significant difference in the detection rate of vertebral dysplasia between DR,MRI and CT(P<0.05).CT showed 80 cases of scoliosis,80 cases of apical vertebrae,and 1 case of spinal cord lesion,while MRI showed 29 cases of scoliosis,40 cases of apical vertebrae,and 9 cases of spinal cord lesion.There were significant differences in the detection rates between CT and MRI(P<0.05).The Cobb Angle of the main curve of scoliosis measured by DR and CT was(71.10°±36.94°)and(59.53°±36.30°)respectively,and the difference was statistically significant(P<0.05).However,there was no significant difference in the measurement of larger Cobb Angle(≥80°)(P>0.05).Conclusion DR,CT and MRI have their own advantages and disadvantages in preoperative evaluation of scoliosis.X-ray and CT should be taken as routine examination items for patients requiring surgical correction.MRI is recommended when patients have neurological symptoms or clinically suspected spinal cord disease or congenital scoliosis.

关 键 词：脊柱侧弯 数字化X线摄影技术 电子计算机断层扫描 磁共振成像 

分 类 号：R687.3[医药卫生—骨科学]