64层CT不同角度MPR图像诊断腰椎弓峡部裂的对照研究

目的研究64层CT不同角度MPR图像诊断腰椎弓峡部裂的价值。方法利用64层CT扫描的50例腰椎弓峡部裂病例的各向同性扫描的容积数据,采用不同角度的多平面重组(MPR)方式进行图像后处理并对照分析:利用MPR模拟出四种扫描模式:①常规的椎间盘扫描方式的断面图像;②腰椎横断面图像;③沿椎弓峡部方向的斜横断位(椎弓反角度扫描)图像;④沿腰椎长轴的矢状断面图像。分析四种方法的峡部裂隙检出率、峡部裂断端错位检出率、碎骨片检出率、假关节形成检出率。结果峡部裂隙检出率以矢状位MPR图像、斜横断位MPR(100%)最高(u=8.51,P<0.05);峡部裂断端错位检出率以矢状位MPR图像(90%)最高(u=4.18,P<0.05);碎骨片检出率以斜横断MPR(28%)和矢状位MPR图像(20%)最高(u=2.08,P<0.05);假关节形成检出率以斜横断MPR(18%)最高(u=2.237,P<0.05)。结论64层CT MPR可以从不同角度不同平面分析椎弓峡部裂的各种征象,对于提高CT对该病的诊断水平具有重要价值。

Comparison of different angle MPR using 64-slice CT in diagnosing lumbar spondylolysis

Objective To study the value of different angle MPR by using 64-slice CT in the diagnosis of spondylolysis. Methods Volume data of isotropic scanning for 50 cases of spondylosis using 64-slice CT were post-processed, compared and analyzed by different angle MPR. Four scanning modes were imitated: Conventional intervertebral disc scanning mode, transverse scanning, oblique transverse scanning along the direction of vertebral arch, longitudinal and sagittal images of lumbar vertebrae. The detective rate of isthmus fissure, dislocation of disruption end, bone fracture piece, false joint of above four methods were analyzed. Results The sensitivity of detecting isthmus tissue was highest by sagittal MPR and oblique transverse MPR images (100)(u=8.51, P<0.05); the sensitivity of detecting disruption end dislocation was highest by sagittal MPR images (90)(u=4.18, P<0.05); the detection rate of fracture piece was highest by oblique transverse MPR images (28) and by sagittal MPR(20)(u=2.08, P<0.05); the detection rate of false joint was highest by oblique transverse MPR images (18)(u=2.237, P<0.05). Conclusion MPR images of 64-slice CT can get spondylolysis images of different angles and planes, and it has important value in improving diagnostic ability of CT for this disease.