發(fā)布時(shí)間：2018-03-17 06:05

  本文選題：256層螺旋CT　切入點(diǎn)：營(yíng)養(yǎng)不良　出處：《吉林大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 通過256層螺旋CT的后處理技術(shù)，評(píng)價(jià)一期后路節(jié)段性椎弓根螺釘系統(tǒng)對(duì)營(yíng)養(yǎng)不良型Ⅰ型神經(jīng)纖維瘤病性脊柱側(cè)凸畸形的臨床治療效果。主要是對(duì)椎弓根螺釘?shù)男螒B(tài)及位置等情況進(jìn)行了256層螺旋CT的檢查以及后期重建處理，觀察了植入的椎弓根螺釘?shù)男螒B(tài)、位置等情況，進(jìn)而從影像學(xué)的角度對(duì)手術(shù)方式進(jìn)行影像學(xué)的評(píng)估。 方法： 對(duì)我院7例營(yíng)養(yǎng)不良型Ⅰ型神經(jīng)纖維瘤病性脊柱側(cè)凸畸形的患者，共96枚椎弓根螺釘進(jìn)行了256層螺旋CT的檢查，運(yùn)用了相應(yīng)的后處理技術(shù)進(jìn)行后期處理，對(duì)術(shù)后椎弓根螺釘置入的效果進(jìn)行了評(píng)估。 結(jié)果： 96枚螺釘全部位于椎弓根的范圍內(nèi)。32枚螺釘穿破了椎弓根的骨壁。椎弓根螺釘?shù)拇┩妇嚯x＜2mm的有23枚；椎弓根螺釘?shù)拇┩妇嚯x在2-4mm之間的有6枚；椎弓根螺釘?shù)拇┩妇嚯x＞4mm的有3枚。胸椎當(dāng)中的椎弓根的螺釘穿透數(shù)目為24枚；腰椎當(dāng)中的椎弓根的螺釘穿透率為7枚。對(duì)于顯示術(shù)后療效的效果上，，平面/曲面重建(MPR/CPR)技術(shù)可以從各個(gè)不同的角度來重新顯示某一個(gè)畸形椎體的冠狀位和失狀位上的圖像，相對(duì)而言是比較方便并且實(shí)用的后處理方法，容積漫游技術(shù)（VRT）的優(yōu)勢(shì)在于它可以進(jìn)行一個(gè)全面的顯示，對(duì)臨床外科的治療有很大的價(jià)值。 結(jié)論： 營(yíng)養(yǎng)不良型Ⅰ型神經(jīng)纖維瘤病性脊柱側(cè)凸畸形在臨床工作當(dāng)中，相對(duì)于其他類型的脊柱側(cè)凸畸形來說比較少見。本研究中的7例營(yíng)養(yǎng)不良型Ⅰ型神經(jīng)纖維瘤病性脊柱側(cè)凸畸形的患者均進(jìn)行了手術(shù)方式為“一期后路節(jié)段性椎弓根螺釘植入術(shù)”的系統(tǒng)治療，我們對(duì)7例術(shù)后的患者進(jìn)行了256層螺旋CT的檢查以及后期重建處理，觀察了植入的椎弓根螺釘?shù)男螒B(tài)、位置等情況，進(jìn)而從影像學(xué)的角度對(duì)手術(shù)方式進(jìn)行評(píng)估。發(fā)現(xiàn)7例患者在接受一期后路節(jié)段性椎弓根螺釘植入術(shù)的系統(tǒng)治療后的療效較為滿意，沒有出現(xiàn)嚴(yán)重的并發(fā)癥。在后處理技術(shù)中，平面/曲面重建(MPR/CPR)技術(shù)相對(duì)來講是一種方便實(shí)用的后處理方法，而容積漫游技術(shù)（VRT）則可以進(jìn)行一個(gè)整體的顯示，從而對(duì)臨床醫(yī)師起到一個(gè)直觀的提示作用。
[Abstract]:Objective:. Through the post processing technology of 256 slice spiral CT, To evaluate the clinical effect of one stage posterior segmental pedicle screw system in the treatment of dystrophy type I neurofibromatosis scoliosis, the 256-slice spiral was performed on the morphology and position of pedicle screw. Ct examination and post-reconstruction, The shape and position of pedicle screw implantation were observed, and the imaging evaluation of the operation was carried out from the point of view of imaging. Methods:. A total of 96 pedicle screws were examined by 256-slice spiral CT in 7 patients with dystrophy type I neurofibromatosis scoliosis in our hospital. The effect of pedicle screw implantation was evaluated. Results:. All the 96 screws were located within the range of pedicle pedicle. 32 screws pierced the bone wall of pedicle pedicle, 23 screws with penetration distance of less than 2 mm, 6 screws with penetration distance between 2 mm and 4 mm, and 6 screws with penetrating distance between 2 mm and 4 mm. The penetrating distance of pedicle screw was more than 4 mm. The number of pedicle screws in thoracic vertebrae was 24, and the penetration rate of pedicle screws in lumbar vertebrae was 7. The plane / surface reconstruction technique MPR-CPR can re-display the coronal and lost images of a deformed vertebral body from different angles, which is a relatively convenient and practical post-processing method. Volume roaming technique (VRT) has the advantage that it can perform a comprehensive display and is of great value for clinical surgical treatment. Conclusion:. Dystrophy type I neurofibromatosis scoliosis in clinical work, Compared with other types of scoliosis, 7 patients with dystrophy type I neurofibromatosis were operated on as one stage posterior segmental pedicle. "systematic treatment of root screw implantation," We performed 256-slice spiral CT examination and post-reconstruction in 7 patients after operation, and observed the shape and position of the pedicle screw implanted. From the perspective of imaging, it was found that 7 patients had satisfactory results after systematic treatment of one-stage posterior segmental pedicle screw implantation, with no serious complications. The plane / surface reconstruction MPR-CPR technique is a convenient and practical post-processing method, while the volumetric roaming technique (VRTT) can be displayed as a whole, thus providing an intuitionistic hint to clinicians.
【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】：2013
【分類號(hào)】：R816.8;R682.13

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