本文選題：能譜CT + 手足肌腱��； 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的： 1、運用寶石能譜CT尋求顯示手足部肌腱的最佳keV單能量。 2、探討寶石能譜CT對正常手足肌腱解剖的顯示價值。 3、探討寶石能譜CT在手足肌腱病變中的初步應(yīng)用。 資料與方法： 對從2010年10月至今因臨床懷疑肌腱病變而來山東省千佛山醫(yī)院影像科檢查的61例患者行手足部能譜CT掃描,采用GE寶石能譜(CT Discovery CT750HD, HDCT)掃描機(jī),能譜掃描模式。掃描層厚5.0mm,間隔5.0mm,掃描模式：Helical full0.6sec GSI-18,最大管電流：640mA,管電壓：140/80KV,螺距：0.531：1,床速：10.62mm/rot,準(zhǔn)直：20.0mm。平均容積CT劑量指數(shù)(CT Dose Index volume, CTDIvol):45.97mGy。掃描范圍：手部包括腕關(guān)節(jié),足部包括踝關(guān)節(jié),必要時加掃前臂和小腿,所有受檢者均行雙側(cè)對比掃描。 將5.0mm層厚的混合能量圖像重建為0.625mm層厚的單能量圖像后,傳至AW4.4工作站,在GSI Viewer視圖下,通過能譜分析軟件,以肌腱及周圍肌肉為感興趣區(qū),選取3個不同層面進(jìn)行測量,分別記錄每一層面具有最佳對比噪聲比(contrast-to-noise ratio, CNR)的keV單能量值,對三個結(jié)果求取其算數(shù)平均值。隨機(jī)抽取30例正常手或足肌腱,用SAS軟件對keV算數(shù)平均值進(jìn)行統(tǒng)計處理。對該30例樣本,選取其顯示肌腱的最佳keV單能量圖像與常規(guī)混合能量圖像,用4分法分別對肌腱顯示的圖像質(zhì)量進(jìn)行評分,采用SPSS17.0統(tǒng)計學(xué)軟件分析比較兩者間差異有無統(tǒng)計學(xué)意義。 選取具有最佳CNR的相應(yīng)單能量系列圖像,分別綜合運用容積再現(xiàn)技術(shù)(Volume Rendering, VR)及多平面重組技術(shù)(Multiplannar Reformation, MPR),必要時輔以曲面重組技術(shù)(Curved Plannar Reformation, CPR),對體內(nèi)植入金屬固定物著,同時加以MARS處理。以目標(biāo)肌腱為中心,將圖像任意轉(zhuǎn)動、切割并調(diào)節(jié)窗寬窗位以達(dá)到顯示肌腱的最佳平面、角度和效果,觀察并記錄每條肌腱的密度、走行、止點、外形及周圍組織情況。 結(jié)果： 1、顯示肌腱的最佳單能量數(shù)據(jù)統(tǒng)計：樣本量30,介于[30,50],行正態(tài)性W檢驗,P0.05有統(tǒng)計學(xué)意義。經(jīng)SAS軟件計算得W=0.956727,P=0.2549a=0.05所以,該樣本來自符合正態(tài)分布的總體。均值：65.07833,標(biāo)準(zhǔn)偏差：2.99701,95%可信區(qū)間：(63.96,66.20)。所以在均值65keV時,能獲得最高的CNR。 最佳keV單能量圖像與常規(guī)混合能量圖像質(zhì)量的評價：兩者評分分別為3.33±0.48、2.87±0.73,采用SPSS17.0統(tǒng)計學(xué)軟件分析,t值2.93,P值0.0050.05,差異有統(tǒng)計學(xué)意義。 2、正常肌腱54例,手24例,足30例。CT表現(xiàn)為位置正常,密度均勻,約87-96Hu,邊界清楚、光滑、銳利,走行連續(xù)、自然。除受檢者指淺屈肌腱、示指伸肌腱、小指伸肌腱末端及部分受檢者橈側(cè)腕屈肌腱、腓骨長肌腱、第三腓骨肌、脛骨后肌腱止點顯示欠佳外,余所有主要手足部肌腱均能清晰顯示。 3、損傷肌腱68例：腫瘤、肌腱縫合或骨折術(shù)后23例,慢性損傷19例,骨折或關(guān)節(jié)脫位13例,骨腫瘤或周圍軟組織腫瘤10例,肌腱斷裂2例,先天畸形1例。診斷準(zhǔn)確率為89.71%(61/68),除肌腱慢性損傷診斷準(zhǔn)確率較低外(12/19),其余病變診斷準(zhǔn)確率達(dá)100%。 結(jié)論： 1、65keV單能量是顯示肌腱的最佳單能量。 2、寶石能譜CT能清晰顯示手足部主要肌腱,且與解剖學(xué)高度一致,但指趾遠(yuǎn)端肌腱顯示欠佳。 3、寶石能譜CT能清晰顯示手足肌腱斷裂、縫合術(shù)后、畸形等,但對肌腱慢性炎性改變顯示欠佳。
[Abstract]:Objective:
1, use gemstone energy spectrum CT to find the best keV single energy of hand and foot tendon.
2, to explore the value of gemstone spectral CT in the anatomy of normal hand and foot tendons.
3, to explore the preliminary application of gemstone spectral CT in hand foot tendon disease.
Information and methods:
61 patients who had been examined by clinical suspicion of tendons from October 2010 to Qianfo Hill hospital in Shandong province were examined by hand foot spectrum CT scan, using GE gemstone spectrum (CT Discovery CT750HD, HDCT) scanner, energy spectrum scanning mode. Scanning layer thickness 5.0mm, interval 5.0mm, scanning mode: Helical full0.6sec GSI-18, maximum tube electricity Flow: 640mA, tube voltage: 140/80KV, spiral distance: 0.531:1, bed speed: 10.62mm/rot, collimation: 20.0mm. average volume CT dose index (CT Dose Index volume, CTDIvol): 45.97mGy. scan range: hand including wrist, foot including ankle joint, if necessary, forearm and calf, all subjects have bilateral contrast scan.
After reconstructing the 5.0mm layer thick mixed energy image into a single energy image with 0.625mm layer thickness, it was passed to the AW4.4 workstation. Under the GSI Viewer view, 3 different layers were selected to measure the best contrast noise ratio (contrast-to-noise ratio, respectively) by using the spectrum analysis software and using the tendon and the surrounding muscles as the region of interest. CNR keV single energy value, the average value of the number of the three results was calculated. 30 cases of normal hand or foot tendon were randomly selected, and the average value of the keV arithmetic was processed by SAS software. The best keV single energy image of the tendon and the conventional mixed energy image were selected for the 30 samples, and the image quality of the tendon displayed by the 4 method was respectively. The SPSS17.0 score was used to analyze and compare the differences between the two groups.
Select the corresponding single energy series with the best CNR, use the volume rendering technique (Volume Rendering, VR) and the multiplane recombination technology (Multiplannar Reformation, MPR). When necessary, the technique of surface recombination (Curved Plannar Reformation, CPR) is used, and the metal fixtures are implanted in the body. At the same time, the MARS is treated with the target. The tendon is the center, the image is rotated at any time, cutting and adjusting the window wide window to show the best plane, angle and effect of the tendon, and observe and record the density of each tendon, walk, stop, shape and surrounding tissue.
Result錛，

本文編號：1855880