多层螺旋CT最大密度投影三维重建在小耳畸形再造患者肋软骨术前评估中的应用  

Application of multi slice spiral CT maximum density projection 3D reconstruction in preoperative evaluation of rib cartilage in patients with small ear deformity reconstruction

作　　者：胡乔 王建业 张磊[1] HU Qiao;WANG Jianye;ZHANG Lei(Henan Nanyang Central Hospital,Henan Province,473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国医疗美容》2023年第12期25-29,共5页China Medical Cosmetology

摘　　要：目的 探讨多层螺旋CT最大密度投影三维重建技术在小耳畸形再造患者肋软骨术前评估中的应用价值。方法 选取2021年1月至2023年10月在我院接受肋软骨整形再造小耳畸形患者68例为研究对象,所有患者术前均采用64排螺旋CT对双侧1~12肋全方位扫描,然后对扫描图像进行容积重建(volume rendering technique,VRT)及最大密度投影(maximum intensity projection,MIP)三维重建处理,观察影像中肋软骨走形、形态、钙化情况,利用图像处理软件中测量工具测量肋软骨全长、近肋骨处宽度和厚度,并与术中取肋软骨后即刻测量数据进行比较,评价术前测量准确性。结果 共处理手术相关肋软骨174根,所有影像均立体、清晰、逼真术前三维成像测量肋软骨全长平均值为(82.96±20.48)mm,与术中实际测量值(81.93±18.56) mm比较,差异无统计学意义(t=0.492,P=0.623);术前测肋软骨宽度为(10.93±2.57) mm,与术中实际测量值(11.15±2.43)mm比较,差异无统计学意义(t=0.821,P=0.413);术前测肋软骨厚度为(8.35±2.14) mm,与术中实际测量值(8.19±2.11) mm比较,差异无统计学意义(t=0.702,P=0.483)。术前通过VRT图像评估出10根肋软骨存在不同程度的局部钙化,钙化斑范围6 mm×17 mm~18 mm×25 mm术中证实该10根肋软骨均存在钙化,与术前评估结果 一致。所有患者均在术前评估的指导下制定手术计划,均顺利完成手术,术后无并发症发生,再造小耳逼真,整形效果满意。结论 多层螺旋CT最大密度投影三维重建技术可在术前对小耳畸形再造患者肋软骨进行无创评估,能够清晰、准确的判断肋软骨组织量,为小耳再造整形手术提供精确指导,具有重要应用价值。Objective Exploring the application value of multi-slice spiral CT maximum density projection 3D reconstruction technology in preoperative evaluation of rib cartilage in patients with small ear malformation reconstruction.Methods 68 patients with small ear deformities undergoing rib cartilage plastic surgery and reconstruction in our hospital from January 2021 to October 2023were selected as the study subjects.All patients underwent preoperative 64 slice spiral CT scans of bilateral 1~12 ribs in all directions,and then volume rendering technology(VRT) and maximum intensity projection(MIP) 3D reconstruction were performed on the scanned images to observe the rib cartilage deformation,morphology,and calcification in the images,Use measurement tools in image processing software to measure the total length,width,and thickness of rib cartilage near the rib,and compare them with intraoperative measurements taken immediately after rib cartilage extraction to evaluate preoperative measurement accuracy.Results A total of 174rib cartilage related to surgery were processed,and all images were three-dimensional,clear,and realistic;The average length of rib cartilage measured by preoperative 3D imaging was(82.96 ± 20.48) mm,and there was no statistically significant difference compared to the actual measurement during surgery(81.93 ± 18.56) mm(=0.492,P=0.623);The preoperative measurement of rib cartilage width was(10.93± 2.57) mm and there was no statistically significant difference compared to the actual intraoperative measurement of(11.15± 2.43) mm(t=0.821,P=0.413);The preoperative measurement of rib cartilage thickness was(8.35±2.14) mm,and there was no statistically significant difference compared to the actual intraoperative measurement of(8.19±2.11) mm(t=0.702,P=0.483).Prior to surgery,VRT images were used to evaluate the presence of varying degrees of local calcification in 10 rib cartilages,with a calcified lesion area of 6 mm × 17 mm~18 mm × 25 mm,During the surgery,it was confirmed that all 10 rib cartilage

关 键 词：多层螺旋CT 容积重建 三维重建 小耳畸形 小耳再造 术前评估 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]