本文選題：寶石CT + 脊柱��； 參考：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討寶石CT能譜成像技術(shù)在去除脊柱金屬植入物放射狀偽影方面的最佳的成像的單能量點，并評價其臨床應(yīng)用價值。 方法：對20例在我院行脊柱外科手術(shù)，，并植入金屬固定物的患者行寶石CT能譜掃描，掃描后獲得（120Kvp）混合能量圖像及70Kev單能量圖像。用能譜分析軟件（GSI viewer）進(jìn)行分析，在40-140Kev（間距10Kev）重建11種單能量圖像，然后選取最佳單能量圖像行金屬偽影消除重建（Metal-Artifacts Reduction System，MARs），獲得MARs能譜圖像(110Kev單能量+MARs圖像）。由本科室3名高年資放射科診斷醫(yī)師參照使用4分量表[1]，來對采集的圖像質(zhì)量高低進(jìn)行主觀目測評分；測量的放射狀偽影為植入椎弓根螺釘前端偽影長度以評價其偽影輕重程度；于每組圖像中選取偽影最重層面(A)行兩次SD值測定記錄為SD1、SD2，同時選擇無或少偽影層面（B）行SD值測定記錄為SD0，作為正常對照。對所獲得數(shù)據(jù)采用spps17.0統(tǒng)計學(xué)軟件包，進(jìn)行配對t檢驗數(shù)據(jù)分析。 結(jié)果：在11種單能量圖像組中，隨著Kev的增加，偽影長度將逐漸縮短，在110-140Kev區(qū)間偽影長度接近于零，且在此區(qū)間各組間偽影長度無明顯差異；110Kev單能量圖像組的偽影指數(shù)和噪聲值最小，主觀評分最高，因此所有20例患者的圖像均于110Kev行MARs重建。MARs能譜圖像組（110Kev單能量+MARS圖像）與混合能量圖像組的主觀評分及偽影長度之間均存在顯著性差異（P=0.0000.05），即MARs單能量圖像組的脊柱金屬植入物放射狀偽影與混合能量組相比，偽影程度明顯降低，圖像質(zhì)量較混合能量圖像組顯著提高。MARs能譜圖像組與最佳單能量圖像組的偽影長度及噪聲值之間存在差異，即MARs能譜圖像組較單能量圖像組的圖像質(zhì)量有所提高。 結(jié)論：在鈦合金材質(zhì)的脊柱金屬植入物患者的單能量圖像組中，110Kev為圖像質(zhì)量最佳的單能量成像點。在減除鈦合金材質(zhì)的脊柱金屬植入物偽影時應(yīng)聯(lián)合應(yīng)用單能量技術(shù)和MARs技術(shù)。寶石CT能譜成像技術(shù)能夠顯著減少脊柱金屬植入物的偽影，使CT圖像的質(zhì)量明顯提高，具有較高的臨床應(yīng)用價值。
[Abstract]:Objective: to investigate the best single energy point for removing radioactive artifacts from metal implants of spine by using gemstone CT energy spectrum imaging technique and to evaluate its clinical value.Methods: twenty patients who underwent spinal surgery in our hospital and were implanted with metal fixator were scanned by Sapphire CT energy spectrum. After scanning, mixed energy images and 70Kev single energy images were obtained.Eleven kinds of single energy images were reconstructed by using the energy spectrum analysis software (GSI viewer), and 11 kinds of single energy images were reconstructed in 40-140 Kevin (interval 10 Kevin). Then the best single energy images were selected for metal artifact elimination and reconstruction of Metal-Artifacts Reduction system Myers, and 110 Kev single energy MARs images were obtained.Three senior radiologists in our department used 4 subscales [1] to evaluate the quality of the collected images.The radial artifact was measured as the anterior artifact length of pedicle screw implantation to evaluate the degree of artifact.Two SD values were recorded as SD1 / SD2 in each group of images, and SD0 was used as the normal control.The obtained data were analyzed by spps17.0 statistical software package and paired t test data.Results: in 11 groups of single energy images, with the increase of Kev, the length of artifacts was gradually shortened, and the length of artifacts was close to zero in the range of 110-140Kev.In this interval, there was no significant difference in artifact length among groups. The artifact index and noise value of 110Kev single energy image group was the smallest, and the subjective score was the highest.Therefore, there was significant difference in the subjective score and artifact length between the 110Kev reconstruction of all 20 patients and the mixed energy image group (110Kev single energy MARS image), that is, the MARs single energy image group, that is, the MARs single energy image group.The radial artifacts of the metal implants in the spine were compared to those of the mixed energy group.Compared with the mixed energy image group, the artifact length and noise value of the energy spectrum image group and the best single energy image group were significantly improved, and there were differences between the artifact length and the noise value of the best single energy image group.That is, the image quality of MARs energy spectrum image group is better than that of single energy image group.Conclusion: 110Kev is the best single energy imaging point in the single energy image group of patients with titanium alloy spinal metal implants.Single energy technique and MARs technique should be used in removing the artifacts of titanium alloy metal implants.Gem CT energy dispersive imaging technique can significantly reduce the artifact of spinal metal implants and improve the quality of CT images, which has high clinical application value.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R816.8

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