多层螺旋CT三维重建后处理在骨肿瘤影像诊断中的应用

背景：多层螺旋CT的出现，成为骨肿瘤影像诊断的有效工具，其扫描速度非常快，得到的图像清晰，而且对患者的辐射量少，使大范围三维扫描成为了现实。 目的：探讨多层螺旋CT三维重建后处理技术在骨肿瘤影像诊断中的应用价值。 方法：由作者应用计算机检索1995/2011万方数据库中与多层螺旋CT扫描及后处理技术诊断骨肿瘤有关的文献，检索关键词为“图像处理，骨肿瘤，体层摄影术，三维后处理，X射线计算机”，限定语言为中文。纳入标准：主题内容与骨肿瘤三维重建相关，针对性较强，相关度高的文献，最大密度投影及表面遮盖三维重组图像和容积漫游技术在骨肿瘤诊断中应用相关的文章。排除重复性研究，较为陈旧的文献，综述和Mete分析类的文献。对资料进行初审，并查看每篇文献后的引文，最终入选20篇符合标准文献。 结果与结论：每一种重建图像均显示骨肿瘤，其中多平面重建准确显示了肿瘤骨的骨破坏、骨膜的改变、骨破坏的范围及肿瘤对周围软组织的侵犯情况，最大密度投影及表面遮盖三维重组图像和容积漫游技术能立体显示骨改变；表面遮盖三维重组图像和容积漫游技术在增强的基础上可以显示肿瘤的供血动脉、静脉和肿瘤血管。后处理图像结合横断层面图像能从不同方向准确显示肿瘤骨的骨破坏、骨膜反应类型、肿瘤的范围及肿瘤对周围组织的侵犯。 

Application of multislice spiral CT combined with three-dimensional reconstructed post-processing techniques for the diagnosis of bone tumo

BACKGROUND: Multislice spiral CT has become an effective tool for imaging diagnosis of bone tumors, the advantages of fast scanning speed, clear image and less radiation make it possible of the large-scale three-dimensional scanning. OBJECTIVE: To investigate the application value of multislice spiral CT combined with three-dimensional reconstructed post-processing techniques for the diagnosis of bone tumors. METHODS: Wanfang database was searched by the first author for the articles on multislice spiral CT and post-processing techniques for the diagnosis of bone tumors from 1995 to 2011. Key words were “image processing, bone tumors, tomography, three-dimensional post-processing, X-ray computer” in Chinese. According to the inclusion criteria, the articles on the three-dimensional reconstruction of bone tumors with highly direction and correlation were included, as well as the articles on the application of maximum intensity projection, surface shaded three-dimensional reformatted images and volume rendering technique in the diagnosis of bone tumors. Repetitive studies, published earlier, review and Meta analysis were eliminated. Finally, a total of 20 articles were included to review according to the inclusion criteria after the primary search. RESULTS AND CONCLUSION: Each reconstructed image can display the bone tumors; the multi-planar reconstructed image can accurately display the bone destruction, periosteal changes, the scope of bone destruction and violation of tumor to the surrounding soft tissue. Maximum intensity projection, surface shaded three-dimensional reformatted images and volume rendering technique can volumetric display the changes of the bone; enhanced surface shaded three-dimensional reformatted images and volume rendering technique can show the tumor feeding arteries, vein and tumor vessels. Post-processing combined with cross-sectional images can accurately show the bone destruction, periosteal reaction type, the extent of the tumor and violation of tumor to the surrounding soft tissue from different directions.