AutoCAD对ImageViewer界面完成的颈椎多平面重建CT图像行定量测量*☆

背景：Silver-PACS系统的功能尚不完善，其图像浏览软件ImageViewer可对序列原始横断面CT图像实施多平面重建，但对重建图像不具有定量电子测量功能。 目的：探索利用AutoCAD2006对ImageViewer重建的下颈椎多平面重建CT图像行定量测量，以弥补现有ImageViewer版本的功能不足。 设计、时间及地点：定量测量试验，2007-06/08在解放军海军总医院放射科完成原始图像扫描，后续定量测量在骨科实验室完成。 材料：8具自愿捐献新鲜下颈椎标本，GE公司的Lightspeed 16排螺旋CT。 方法：螺旋CT对俯卧位颈椎标本行5 mm层厚连续容积扫描，标本纵轴需同CT扫描轴相平行，在AW工作站以0.625 mm层厚、0.625 mm间隔内插法获得原始连续横断面图像。以Dicom格式存储后在ImageViewer界面打开，重建出满意的多平面重建CT图像；利用电脑的Prt Sc功能，在Adobe Photoshop软件中将重建好的带刻度标示的MPR图像转化为*. JPG格式保存；以光栅图像格式在AutoCAD软件中打开，完成定量电子测量。 主要观察指标：重建颈椎弓根内、外、上、下壁及上、下关节突前壁皮质厚度。 结果：在ImageViewer界面成功重建了下颈椎多平面重建CT图像，利用AutoCAD对重建图像成功进行颈椎弓根四壁皮质厚度及上下关节突前壁厚度的电子定量测量，发现颈椎弓根外壁皮质明显薄于其他各壁（P < 0.05）。 结论：以序列原始横断面CT图像为基础，ImageViewer界面可重建出满意的多平面重建CT图像，在AutoCAD中可对重建图像精确定量测量，弥补了ImageViewer软件现有版本的不足。

AutoCAD for quantitative measurement of cervical multiple planar reconstruction CT images reconstructed in ImageViewer interface

BACKGROUND: Silver-PACS function is not perfect. The present version 5.0 of its ImageViewer interface could reconstructed qualified multiple planar reconstruction (MPR)-CT images with reference ruler based on raw sequential transaxial CT images for further analysis, but it could not fulfill electronic quantitative measurement on these MPR-CT images. OBJECTIVE: To explore the possibility of using AutoCAD2006 software to perform quantitative measurement on cervical MPR CT images which were reconstructed with ImageViewer interface at the basis of sequential raw tranaxial CT images. DESIGN, TIME AND SETTING: Electronic quantitative measurement. The sequential raw transaxial CT image scanning was performed at the Radiology Department of Navy General Hospital, and MPR images were reconstructed and measured at Laboratory of Orthopaedic Department of Navy General Hospital from June to August 2007. MATERIALS: Eight fresh cervical spine samples were from volunteers, and 16-slice multidetector CT (GE, USA). METHODS: Volumetric CT scanning was performed on the fresh cervical spine samples on prone position with 5-mm thickness. Sequential raw cervical transaxial CT image data of each sample were generated by interpolation reconstruction method for a 0.625-mm thickness at 0.625 mm reconstruction intervals and saved as Dicom format in Advantage Workstation. Based on these raw transaxial images, MPR images with reference ruler present were reformatted with the post-processing function of ImageViewer interface and saved as JPG format. These digitized images were then opened in AutoCAD2006 program as raster images to perform quantitative measurement. MAIN OUTCOME MEASURES: Thickness of medial, lateral superior, and inferior cortices of the pedicle, and thickness of anterior cortices of superior and inferior articularis of reconstructed MPR-CT subaxial images. RESULTS: Ideal cervical MPR CT images with reference ruler were successfully reconstructed with ImageViewer software. These images (*.JPG format) were successfully opened in AutoCAD program as raster images and electronic quantitative measurement of was performed as required, which showed the lateral cortex of subaxial pedicle was statistically thinner than its relative medial, superior and inferior cortices of pedicle, as well as anterior cortices of superior and inferior articularis (P < 0.05). CONCLUSION: ImageViewer software substation of Silver PACS system could reconstruct qualified MPR CT images with reference ruler present at the basis of sequential raw transaxial images. The electronic quantitative measurement in AutoCAD 2006 compensates the drawback of present ImageViewer software.