本文選題：下腰痛　切入點(diǎn)：橫斷面積　出處：《吉林大學(xué)》2012年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：通過(guò)利用腰部多排螺旋CT掃描重建圖像，對(duì)腰部肌群進(jìn)行相關(guān)測(cè)量，提供出橫斷面積及CT值等影像資料，為臨床腰部疾病診斷提供發(fā)病機(jī)制、干預(yù)作用等基本信息的依據(jù)。同時(shí)對(duì)男女不同年齡組人群進(jìn)行比較，為腰部疾病的診斷、治療和預(yù)防提供詳實(shí)可靠的測(cè)量數(shù)據(jù)。 方法：收集我院2010年9月至2011年4月間在吉林大學(xué)中日聯(lián)誼醫(yī)院放射科檢查的240例腰部CT掃描圖像重建（體檢病人包括患下腰痛患者）在不同的腰椎橫突水平測(cè)量腰大肌、腰方肌、豎脊肌橫斷面積和平均CT值等。其中20-29歲為A組、29-39歲為B組、39-49歲為C組、49-59歲為D組、59-69歲為E組、70-79歲為F組。每組40例患者（男20例、女20例）。檢查前排除金屬偽影干擾可能，囑患者仰臥位平躺，放松、平靜呼吸。本研究采用ToshibaActivion16排螺旋CT掃描儀器，，掃描參數(shù)：電壓120kV、電流250mA、層厚1mm，層間距1mm容積掃描。應(yīng)用Xiphoid軟件進(jìn)行數(shù)據(jù)測(cè)量及后處理，獲取不同層水平腰部肌群的橫斷面積及CT值。采用SPSS16.0統(tǒng)計(jì)軟件，分別求出平均數(shù)、標(biāo)準(zhǔn)差和P值等，并對(duì)各組進(jìn)行方差分析，當(dāng)P0.05時(shí)有統(tǒng)計(jì)學(xué)意義。 結(jié)果：男性腰大肌橫斷面積平均值由A組到F組分別為14.18cm~2、14.18cm~2、13.92cm~2、11.66cm~2、11.11cm~2、10.32cm~2，平均CT值52.85HU、51.19HU、46.99HU、43.56HU、40.88HU、39.51HU。女性腰大肌橫斷面積平均值由A組到F組分別為7.54cm~2、8.20cm~2、8.16cm~2、8.18cm~2、7.59cm~2、7.06cm~2，平均CT值48.51HU、45.13HU、41.0~2HU、37.5~2HU、36.46HU、31.11HU。男性腰方肌橫斷面積平均值由A組到F組分別為13.40cm~2、13.53cm~2、13.33cm~2、11.17cm~2、10.57cm~2、9.73cm~2，平均CT值53.16HU、51.54HU、46.81HU、43.~25HU、40.65HU、39.36HU。女性腰方肌橫斷面積平均值由A組到F組分別為8.1~2cm~2、8.83cm~2、8.84cm~2、8.83cm~2、8.22cm~2、7.68cm~2，平均CT值48.71HU、45.33HU、40.97HU、37.18HU、36.17HU、31.09HU。男性豎脊肌橫斷面積平均值由A組到F組分別為16.93cm~2、16.81cm~2、16.57cm~2、13.78cm~2、13.33cm~2、12.52cm~2，平均CT值5~2.1HU、50.31HU、46.10HU、41.93HU、39.06HU、37.59HU。女性豎脊肌橫斷面積平均值由A組到F組分別為10.90cm~2、11.78cm~2、11.65cm~2、11.31cm~2、10.59cm~2、10.18cm~2，平均CT值47.42HU、44.34HU、39.9~2HU、35.47HU、33.41HU、~26.99HU。結(jié)論：通過(guò)對(duì)~240例圖像重建分析，多排螺旋CT能清楚顯示腰部肌群及鄰近周?chē)鞴俚慕馄式Y(jié)構(gòu)，并能對(duì)骨質(zhì)密度有較好的分辨，但對(duì)豎脊肌的分區(qū)準(zhǔn)確性稍差。相同性別的不同年齡組腰部肌群測(cè)量橫斷面積由于老化肌肉的纖維數(shù)量減少、脂肪沉積而呈下降趨勢(shì)，在39-49歲年齡組變化趨勢(shì)明顯。相同年齡組的不同性別腰部肌群測(cè)量存在不同差異，男性肌肉橫斷面積略大于女性，且變化趨勢(shì)亦不相同，女性下降曲線略早于男性。結(jié)合臨床資料，椎體的穩(wěn)定與腰部肌群息息相關(guān)，當(dāng)出現(xiàn)生理曲度側(cè)彎或滑脫時(shí)，兩側(cè)腰部肌群形態(tài)學(xué)往往發(fā)生了變化。腰部肌群橫斷面積及CT值等形態(tài)學(xué)參數(shù)，為臨床診斷、干預(yù)治療、康復(fù)鍛煉等提供有力指導(dǎo)數(shù)據(jù)。
[Abstract]:Objective: through the use of the multi slice spiral CT reconstruction images of waist muscle groups for measurement, provide cross-sectional area and CT value of image data, provide mechanisms for clinical diagnosis of lumbar disease, intervention and other basic information basis. At the same time for men and women of different age groups were compared for the diagnosis of lumbar disease the treatment and prevention to provide detailed and reliable measurement data.
Methods: in our hospital from September 2010 to April 2011 in the Department of Radiology examination in China Japan Union Hospital of Jilin University in 240 cases of lumbar CT scan image reconstruction (including a medical examination of a patient with low back pain patients) in the lumbar vertebra waist level of different muscles, waist muscle, erector spinae muscle cross-sectional area and the average CT value of 20-29. At the age of 29-39 years for the A group, B group, 39-49 C group, 49-59 D group, 59-69 E group, 70-79 F group. Each group of 40 patients (male 20 cases, female 20 cases). Before the examination, exclude metal artifact, ask the patient to lie in a supine position. Relax, calm breathing. This study uses ToshibaActivion16 scan parameters: slice spiral CT scanning instrument, voltage 120kV, current 250mA, thickness 1mm, spacing 1mm volume scanning. Xiphoid software was used for data measurement and postprocessing, get a different level of waist muscle cross-sectional area and CT value. Using SPSS16.0 statistical software The average number, the standard deviation and the P value were calculated, and the variance analysis was carried out in each group. When P0.05 was statistically significant.
Results: male psoas muscle cross-sectional area average value from A group to F group were 14.18cm~2,14.18cm~2,13.92cm~2,11.66cm~2,11.11cm~2,10.32cm~2, the average CT value of 52.85HU, 51.19HU, 46.99HU, 43.56HU, 40.88HU, 39.51HU. female psoas muscle cross-sectional area average value from A group to F group were 7.54cm~2,8.20cm~2,8.16cm~2,8.18cm~2,7.59cm~2,7.06cm~2, the average CT value of 48.51HU, 45.13HU, 41.0~2HU, 37.5~2HU, 36.46HU 31.11HU., male waist muscle cross-sectional area average value from A group to F group were 13.40cm~2,13.53cm~2,13.33cm~2,11.17cm~2,10.57cm~2,9.73cm~2, average CT value of 53.16HU, 51.54HU, 46.81HU, 43.~25HU, 40.65HU, 39.36HU. female waist muscle cross-sectional area average value from A group to F group were 8.1~2cm~2,8.83cm~2,8.84cm~2,8.83cm~2,8.22cm~2,7.68cm~2, the average CT value of 48.71HU, 45.33HU, 40.97HU, 37.18HU. 36.17HU 31.09HU., male erector spinae muscle cross-sectional area average By the A group to F group were 16.93cm~2,16.81cm~2,16.57cm~2,13.78cm~2,13.33cm~2,12.52cm~2, the average CT value of 5~2.1HU, 50.31HU, 46.10HU, 41.93HU, 39.06HU, 37.59HU. female erector spinae muscle cross-sectional area average value from A group to F group were 10.90cm~2,11.78cm~2,11.65cm~2,11.31cm~ 2,10.59cm~2,10.18cm~2, the average CT value 47.42HU, 44.34HU, 39.9~2HU, 35.47HU, 33.41HU, ~26.99HU.. Conclusion: through the analysis of ~240 cases image reconstruction, multi slice spiral CT can clearly display the anatomical structure around the waist muscle groups and adjacent organs, and can have a better resolution on bone density, but the partition accuracy of erector spinae muscle after different age groups. Waist muscle groups of the same sex to measure cross-sectional area due to the number of aging muscle fibers reduced fat deposition a downward trend, in the 39-49 year old age group. There is an obvious trend of measuring different gender waist muscle groups of the same age groups Differences, male muscle cross-sectional area is slightly larger than the female, and the trend is not the same, the female decline curve slightly earlier than men. Combined with clinical data, the vertebral stability is closely related with the waist muscle groups, when the physiological curvature of scoliosis or spondylolisthesis, on both sides of the waist muscle morphology often changed. The morphological parameters of the waist muscle group cross-sectional area and CT value for clinical diagnosis, treatment, and rehabilitation exercise and provide strong guidance data.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R816.8

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