本文選題：雙源CT　切入點(diǎn)：容積成像　出處：《青海大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的運(yùn)用雙源CT多平面重建、容積成像及雙能量成像等技術(shù)，與關(guān)節(jié)鏡對(duì)照，分析交叉韌帶損傷的診斷符合率及交叉韌帶損傷術(shù)前和術(shù)后影像特點(diǎn)。方法收集2012年3月-2013年3月期間有單側(cè)膝關(guān)節(jié)外傷史，并經(jīng)臨床檢查，診斷為疑似交叉韌帶損傷的患者35例。采用雙源CT對(duì)所有術(shù)前和部分術(shù)后病例行雙膝關(guān)節(jié)雙能量容積掃描。通過(guò)后處理工作站對(duì)所得數(shù)據(jù)進(jìn)行多平面重建、容積成像及雙能圖像處理，對(duì)雙側(cè)交叉韌帶CT值（Hu）、長(zhǎng)度（mm）及起始段（mm）、中段（mm）和末段（mm）的厚度進(jìn)行測(cè)量，并對(duì)交叉韌帶損傷進(jìn)行診斷，明確交叉韌帶有無(wú)損傷。35例患者均進(jìn)行關(guān)節(jié)鏡檢查。對(duì)所得數(shù)值進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果1.CT診斷結(jié)果與關(guān)節(jié)鏡檢查結(jié)果比較，陽(yáng)性診斷率為74.3%。2.患側(cè)交叉韌帶CT值均比正常側(cè)不同程度降低，最大差值26Hu，最小差值2Hu；起始段增厚14例，中段增厚11例；末段增厚6例。3.關(guān)節(jié)鏡確診為損傷的有30例；右側(cè)19例，左側(cè)11例；前交叉韌帶23例，后交叉韌帶6例，前后交叉韌帶同時(shí)損傷1例；起始段14例，中段11例，末段6例；完全斷裂9例，部分?jǐn)嗔?2例；單純韌帶損傷8例，合并半月板等其他損傷23例；交叉韌帶正常5例，均為半月板損傷。4.兩種檢查方法X2=0.8，P＞0.05，無(wú)統(tǒng)計(jì)學(xué)意義，Kappa值為0.646；正常側(cè)與患側(cè)CT值、起始段、中段厚度和后交叉韌帶配對(duì)分析，差別具有統(tǒng)計(jì)學(xué)意義（P＜0.05）；前交叉韌帶長(zhǎng)度和末段厚度，，差別無(wú)統(tǒng)計(jì)意義（P＞0.05）。5.雙能肌腱韌帶模式圖像，對(duì)交叉韌帶形態(tài)、走行顯示較好，對(duì)交叉韌帶損傷診斷符合率約為86.7%。6.交叉韌帶損傷術(shù)后圖像，對(duì)骨隧道顯示清晰。結(jié)論1.雙源CT容積成像對(duì)膝關(guān)節(jié)交叉韌帶損傷診斷具有一定臨床價(jià)值；2.雙源CT能夠通過(guò)測(cè)量交叉韌帶的CT值和起始段、中段的厚度對(duì)部分損傷進(jìn)行評(píng)價(jià)。3.重建圖像對(duì)術(shù)后韌帶顯示有限，但對(duì)骨隧道顯示效果較好。
[Abstract]:Objective to compare dual-source CT multiplanar reconstruction, volumetric imaging and dual-energy imaging with arthroscopy. To analyze the diagnostic coincidence rate of cruciate ligament injury and the imaging features before and after cruciate ligament injury. Methods A history of unilateral knee joint injury was collected from March 2012 to March 2013. Thirty-five patients were diagnosed as suspected cruciate ligament injury. Dual source CT scanning was performed on all patients before and after operation. The data were reconstructed by multiplanar reconstruction with postprocessing workstation. Volume imaging and dual-energy image processing were performed to measure the thickness of bilateral cruciate ligament (CT) and the initial, middle and end segments of cruciate ligament, and to diagnose the injury of cruciate ligament. All 35 patients with cruciate ligament injury were examined by arthroscopy. The results were statistically analyzed. 1. The results of CT diagnosis were compared with those of arthroscopy. The positive diagnosis rate was 74.3.2. the CT value of the affected cruciate ligament was lower than that of the normal side in varying degrees, the maximum difference value was 26Hu, the minimum difference value was 2Hu. the initial segment thickened in 14 cases, the middle segment thickened in 11 cases, the last segment thickened in 6 cases .3.The arthroscopy confirmed the injury in 30 cases, the right side in 19 cases. Left 11 cases, anterior cruciate ligament 23 cases, posterior cruciate ligament 6 cases, anterior cruciate ligament 1 case, initial 14 cases, middle 11 cases, end 6 cases, complete rupture 9 cases, partial rupture 22 cases, simple ligament injury 8 cases. There were 23 cases with meniscus and other injuries, 5 cases with normal cruciate ligament, and 4 cases with meniscus injury. The two methods of examination were X _ (2) O _ (0.8) P > 0.05, no significant Kappa value was 0.646, CT value of normal side and affected side, initial segment, middle segment thickness and posterior cruciate ligament were analyzed. The difference was statistically significant (P < 0.05), the length and thickness of anterior cruciate ligament were not statistically significant (P > 0.05). The diagnostic coincidence rate of cruciate ligament injury was about 86.7%. Conclusion: Dual-source CT volumetric imaging has certain clinical value in the diagnosis of cruciate ligament injury of knee joint 2.Dual-source CT can measure the CT value and initial segment of cruciate ligament. The thickness of the middle segment was used to evaluate the partial injury. 3. The reconstruction image was limited in displaying the postoperative ligament, but it was better for the bone tunnel.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.8

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