本文選題：髖關(guān)節(jié)置換 + 去金屬偽影技術(shù)��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:評估256層螺旋CT金屬偽影減除技術(shù)(O-MAR,Orthopedic Metal Artifact Reduction)對髖關(guān)節(jié)置換術(shù)后患者所獲的CT圖像中金屬偽影減除的效果,以期達到不增加患者輻射劑量的前提下獲得良好圖像質(zhì)量的目的,保證髖關(guān)節(jié)置換術(shù)后影像學(xué)評估有效進行。材料和方法:此項研究共包括40例接受全髖關(guān)節(jié)置換術(shù)的成年患者(男女比例21:19)。所有患者均接受飛利浦256 i CT檢查,CT掃描均采用相同的技術(shù)參數(shù)。研究分組設(shè)置如下:用常規(guī)掃描方案獲得的原始數(shù)據(jù)作為非O-MAR組,經(jīng)O-MAR重建處理后的數(shù)據(jù)作為O-MAR組。對圖像質(zhì)量的評價通過客觀評價和主觀評價兩種方式進行�？陀^評價通過對近端偽影最大層面和遠端偽影最小層面減金屬偽影有效程度進行量化來評估,即通過測量并比較客觀圖像噪聲(Objective Image Noise,OIN)來進行評估。主觀評價通過雙盲獨立的兩名閱片者在CT軸位圖像分別對金屬偽影、圖像清晰度、結(jié)構(gòu)自然逼真度及診斷信心評分,記錄并進行統(tǒng)計學(xué)分析。結(jié)果:客觀評價,近端偽影最大層面,對比非O-MAR組,O-MAR組顯示更低的OIN值(59.90±21.51和81.12±26.00,t=17.17,P=0.00)。遠端偽影最小層面,兩組的OIN值在數(shù)值上非常接近(35.40±0.97和35.37±0.96,t=1.94,P=0.06)。主觀評價,O-MAR組圖像金屬偽影明顯減少,圖像清晰度、結(jié)構(gòu)自然逼真度及診斷信心均有提高。兩位醫(yī)師均在O-MAR組辨認具體解剖結(jié)構(gòu)時有較高的診斷信心。金屬偽影范圍評分:4.00(1)和2.00(1),Z=-5.90,P=0.00;圖像清晰度評分:3.00(1)和2.00(1),Z=-5.47,P=0.00。結(jié)構(gòu)自然度評分:3.00(1)和2.00(1),Z=-5.62,P=0.00,診斷信心4.00(1)和2.50(1),Z=-5.96,P=0.00。但是有9例患者中出現(xiàn)O-MAR相關(guān)新偽影。結(jié)論:應(yīng)用O-MAR技術(shù)能減少髖關(guān)節(jié)假體周圍的金屬偽影,減低圖像噪聲,獲得更好的圖像質(zhì)量。同時O-MAR技術(shù)增強了觀察者對髖關(guān)節(jié)置換假體附近解剖結(jié)構(gòu)的能力和診斷信心,從而提高對存在金屬偽影患者影像診斷的可靠性。
[Abstract]:Objective: to evaluate the effect of metal artifact subtraction technique of 256-slice spiral CT in patients with hip arthroplasty by orthopedic Metal Artifact Reduction). The aim is to obtain good image quality without increasing the radiation dose, and to ensure the effective evaluation of hip arthroplasty. Materials and methods: the study included 40 adult patients undergoing total hip replacement (21: 19% male to female). All patients underwent Philips 256 i CT scan with the same technical parameters. The study group is set up as follows: the original data obtained by the conventional scanning scheme is used as a non-O-MAR group, and the data after O-MAR reconstruction is taken as a O-MAR group. The evaluation of image quality is carried out by objective evaluation and subjective evaluation. Objective evaluation is evaluated by quantifying the maximum level of proximal artifact and the minimum level of distal artifact to subtract metal artifact, that is, by measuring and comparing objective image noise with object Image NoiseOINs. Subjective evaluation of metal artifacts, image sharpness, natural fidelity of structure and diagnostic confidence score were recorded and statistically analyzed by two double-blind independent film readers in CT axial images. Results: objective evaluation, the maximum level of proximal artifact, showed a lower OIN value of 59.90 鹵21.51 and 81.12 鹵26.00 t ~ (17.17) P ~ (0.000) than that of non-O-MAR group. At the minimum level of distal artifact, the OIN values of the two groups were very close to the values of 35.40 鹵0.97 and 35.37 鹵0.96, respectively. In the subjective evaluation group, the metal artifact was decreased, the image definition, the natural fidelity of the structure and the diagnostic confidence were improved. Both physicians had high diagnostic confidence in identifying specific anatomical structures in the O-MAR group. Metal artifact range score of: 4.00 / 1) and 2.00 / 1 / 1 / 1 / 2 / 0 / 0 / 1 / 1 / 1 / 2: 3.00 / 1) and 2.00 / 1 / 1) and 2.00 / 1 / 1 / 1 / 1 / 2 / 0 / 1 / 2 / 00 / 1 / 2 / 00 / 1 / 1 / 2. 00 / 1 / 1 / 2. Structural naturalness score: 3. 00 1) and 2. 00 0. 1 0. 0. 0. 0. 0. 0. 0 and 2. 00%-5. 62% P0. 000. Diagnostic confidence 4. 00. 1) and 2. 50? 1? -5.96? P0. 00. However, new artifacts associated with O-MAR were found in 9 patients. Conclusion: the application of O-MAR technique can reduce the metal artifacts around hip prosthesis, reduce image noise and obtain better image quality. At the same time, O-MAR technique enhanced the ability and diagnostic confidence of the observer to the anatomical structure near the hip replacement prosthesis, thus improving the reliability of the imaging diagnosis of the patients with metal artifact.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4;R816.8

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