本文選題：磁共振 + 影像學(xué)評(píng)估��； 參考：《浙江大學(xué)》2015年碩士論文

【摘要】：目的探討磁共振(MRI)在評(píng)估腰椎后路椎體間融合結(jié)合椎弓根螺釘內(nèi)固定術(shù)后椎體間融合情況的臨床應(yīng)用價(jià)值。 方法回顧性分析2008年3月至2012年3月間因腰椎退變性疾病行單節(jié)段經(jīng)椎間孔腰椎椎體間植骨融合內(nèi)固定術(shù)(TLIF)且術(shù)后有癥狀的31例患者的影像學(xué)隨訪資料。分析術(shù)后3月、6月、1年、2年的腰椎正側(cè)位X線、CT掃描重建、MRI檢查以評(píng)估椎體間融合狀態(tài)。 結(jié)果術(shù)后3月、6月、1年、2年隨訪時(shí)腰椎X線、CT掃描重建及MRI所示椎體間融合率分別為16.1%、6.45%、0%；80.7%、61.3%、58.1%；96.8%、83.8%、87.1%和100%、96.8%、96.8%。術(shù)后6月與術(shù)后3月的融合率進(jìn)行比較,X線片(χ2=25.833,P=0.000).CT掃描重建(χ2=20.811,P=0.000)和MRI(χ2=25.364,P=0.000)的融合率差異均有統(tǒng)計(jì)學(xué)意義。術(shù)后1年與術(shù)后6月的融合率進(jìn)行比較,MRI(χ2=6.565,P=0.021)的融合率差異有統(tǒng)計(jì)學(xué)意義,而CT掃描重建(χ2=3.971,P=0.086)和X線片(χ2=4.026,P=0.104)的差異無(wú)統(tǒng)計(jì)學(xué)意義。術(shù)后2年與術(shù)后1年融合率相比較,X線片(χ2=1.016,P=1.000).CT掃描重建(χ2=2.952,P=0.195)和MRI(χ2=1.958,P=0.354)的融合率差異均無(wú)統(tǒng)計(jì)學(xué)意義,但后兩者仍發(fā)現(xiàn)相當(dāng)數(shù)量的病例在融合器內(nèi)外有新生骨出現(xiàn)。術(shù)后3月、6月、1年、2年融合率各評(píng)估方法之間的結(jié)果雖有差異,但無(wú)統(tǒng)計(jì)學(xué)意義。各時(shí)間點(diǎn)CT掃描重建和MRI的融合率評(píng)判結(jié)果之間具有高度一致性(90.3%-100%)。 結(jié)論通過(guò)融合節(jié)段終板下骨信號(hào)變化及融合區(qū)域的信號(hào)連續(xù)性,MRI可以較為準(zhǔn)確地判定椎體間融合術(shù)后骨性融合狀態(tài)。MRI評(píng)估椎體間融合需要2年以上的隨訪時(shí)間。MRI可以作為腰椎椎體間融合術(shù)后仍有癥狀患者的融合狀態(tài)評(píng)估的優(yōu)選方法。
[Abstract]:Objective to evaluate the clinical value of magnetic resonance imaging (MRI) in the evaluation of posterior lumbar interbody fusion combined with pedicle screw fixation. Methods from March 2008 to March 2012, the imaging data of 31 patients with symptoms of lumbar degenerative disease were analyzed retrospectively. Three months, six months, one year and two years after operation, the anterior and lateral lumbar vertebrae were analyzed with CT scan and MRI to evaluate the status of lumbar interbody fusion. Results at 3 months, 6 months, 1 year and 2 years of follow-up, the rates of lumbar X-ray CT reconstruction and interbody fusion revealed by MRI were 16.1and 6.450.The rate was 87.1% and 96.8%, respectively. There were significant differences in the fusion rate between 6 months after operation and 3 months after operation (蠂 ~ 2 ~ 2 ~ (25. 83) P ~ (0.000) ~ (0.000) and MRI (蠂 ~ (2) ~ (2) ~ (25. 364) P ~ (0.000) with CT scan reconstruction (蠂 ~ 2 ~ 2 ~ (20. 811) P ~ (0.000) and MRI (蠂 ~ 2 ~ 2 ~ (25. 364) P ~ (0.000). The fusion rate of MRI was significantly higher than that of 6 months after operation (蠂 ~ 2 ~ 2 ~ (6.565) P ~ (0.021), but there was no significant difference between CT scan (蠂 ~ (2) ~ (3) 971) and X-ray (蠂 ~ (2) 4.026 ~ (0.104). There was no significant difference in the fusion rate between 2 years after operation and 1 year after operation (蠂 ~ 2 ~ 2 ~ (1.016) P ~ (1.000). Ct scan reconstruction (蠂 ~ (2) 2 ~ (2) 952) P ~ (0.195) and MRI (蠂 ~ (2) ~ (1.958) P ~ (0.354), but a significant number of cases were still found to have new bone in and out of the fusion cage. Three months, six months, one year and two years after surgery, the results of fusion rate were different, but there was no statistical significance. There was a high consistency between CT reconstruction and fusion rate of MRI at different time points (90.3- 100). Conclusion MRI can accurately determine the status of bone fusion after interbody fusion. It takes more than 2 years of follow-up time. MRI to evaluate interbody fusion. It can be used to evaluate the fusion status of patients with symptoms after lumbar interbody fusion.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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