摘要
目的评价CT三维重建在先天性脊柱侧凸诊断和治疗中的价值。方法对76例先天性脊柱侧凸的患者行脊柱全长X线和CT三维重建检查,比较二者的结果。根据X线片和CT三维重建结果,将患者分为三组,第Ⅰ组为CT三维重建没有提供比X线片更多的信息;第Ⅱ组为CT三维重建进一步证实了X线片上存在但是很模糊的信息,明确了畸形的类型;第Ⅲ组为CT三维重建发现了X线片上没有发现的新信息。结果第Ⅰ组11例(14.5%),年龄2～16岁,Cobb角为28°～102°,平均55.60°±21.06°;第Ⅱ组49例(64.5%),年龄4～28岁,Cobb角为20°～115°,平均55.41°±23.44°;第Ⅲ组16例(21.0%),年龄6～16岁,Cobb角为37°～145°,平均73.19°±28.18°。三组之间年龄相近,差异无统计学意义(P=0.052),而三组侧凸Cobb角之间差异有统计学意义(P=0.039)。结论CT三维重建能够更好地显示先天性脊柱侧凸的情况,提供大量X线片无法显示的信息,特别是可以清晰显示严重的脊柱畸形,有助于判断先天性脊柱侧凸的类型和累及节段,为临床制定个性化的手术方案提供依据。
Objective To analyze the value of three-dimensional computed tomography （CT） reconstruction imaging for the diagnosis and treatment of congenital scoliosis. Methods 76 patients with congenital scoliosis were examined with X-ray of total spine and three-dimensional CT reconstruction, and the resuits were analyzed. Compared with X-ray film, the findings with the CT imaging were classified into three groups： Group Ⅰ, no supplementary useful information was obtained; Group Ⅱ , further confirmation of findings which were unclear or ambiguous on X-ray film, with improved visualization and comprehension of the type of the deformity; Group Ⅲ, substantial new information was obtained. Results Group Ⅰ ： 11 （14.5%）patients, without supplementary useful information obtained with three-dimensional CT reconstruction ilnaging. The patients aged from 2 to 16 years （11.00±10.09 years）, and the Cobb angle ranged from 28°to 102°（55.60°±21.06°）. Group Ⅱ ： 49 （64.5%） patients, with confirmatory finding or improved visualization and comprehension of the previously identified deformities obtained with CT imaging. The 49 patients aged from 4 to 28 years （13.53±4.47 years）, and the Cobb angle ranged from 20°to 115° （55.41°±23.44°）. Group Ⅲ： 16 （21%） patients, with substantial new information obtained with CT reeonstruction images which was unrecognized with X-ray film. The patients aged from 6 to 16 years （12.88±2.68 years）,and the Cobb angle ranged from 37°to 145°（73.19°±28.18°）. The difference of age of patients between 3 groups was of no significance （P=0.052）, but the difference of Cobb angle between 3 groups was significant statistically （P=0.039）.Conclusion Three-dimensional and mulitiplanar reformatted CT imaging allows better visualization and understanding of the deformities of seoliosis, and supplementary useful information may be obtained which was obscure or unrecognized with X-ray film, especially for patients with severe deformities. Its application in clinical practice may contribute to the diagnosis of the type of deformity and the segments involved, as well as the individualized operative planning.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2005年第8期449-452,共4页
Chinese Journal of Orthopaedics
