基于不同噪声指数的下肢全长CT在机器人辅助全膝关节置换术中的应用效果  

Application of full-length lower extremity CT with various noise index in robot-assisted total knee arthroplasty

作　　者：王毅[1] 高亚岭 胡佩岩[1] 单鹏程[1] 孙辉 张娟[1] WANG Yi;GAO Yaling;HU Peiyan;SHAN Pengcheng;SUN Hui;ZHANG Juan(Department of Radiology,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院放射科,北京100102

出　　处：《实用放射学杂志》2025年第3期496-500,共5页Journal of Practical Radiology

摘　　要：目的 探讨在不同噪声指数(NI)下行下肢全长CT扫描,其图像质量以及辐射剂量对机器人辅助全膝关节置换术(RTKA)的应用价值.方法 选取80例行RTKA的患者,将其按照不同的NI随机分为NI=8、NI=18、NI=28、NI=38共 4组,并对下肢全长CT图像和容积再现(VR)技术后处理的三维骨骼模型进行主观评分,客观评价使用剂量长度乘积(DLP)、容积CT剂量指数(CTDIvol)和髋-膝-踝角(HKA)3个指标,分析下肢全长CT扫描在RTKA中的应用价值.结果 (1)随着NI值的升高,薄层图像主观评分下降,在8~18之间均可达到影像诊断标准,>18则不被接受.(2)随着NI值的升高,VR骨骼模型均可达到RTKA接受标准.(3)随着NI值的升高,DLP和CTDIvol逐渐减小,差异有统计学意义(P<0.05),但在NI=28与NI=38的组间比较中,差异无统计学意义(P>0.05).结论 采用NI=28进行下肢全长CT扫描,既可满足RTKA术前规划需求,同时辐射剂量可降至最低.Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

关 键 词：下肢全长 低剂量CT 噪声指数 机器人辅助全膝关节置换术 

分 类 号：R658.3[医药卫生—外科学] R814.42[医药卫生—临床医学] R687.4