【摘要】：目的：通過研究低劑量螺旋CT三維重建在骨骺損傷早期診斷分型中的臨床作用,來探討低劑量螺旋CT三維重建的臨床價值和其對圖像質(zhì)量的影響,從而進一步指導(dǎo)臨床治療。 方法：隨機選擇16歲以下兒童骨骺損傷病例30例,早期選擇普通X線攝片和低劑量螺旋CT三維重建,確定骨骺損傷類型,指導(dǎo)臨床選擇相應(yīng)的治療措施,隨訪2年觀察肢體骺板出現(xiàn)骨橋和骺早閉以及肢體關(guān)節(jié)發(fā)育畸形的出現(xiàn)率。將低劑量螺旋CT三維重建圖像與既往相關(guān)病例中常規(guī)劑量圖像分為兩組,兩組均為30例,獲得的圖像通過雙盲法進行質(zhì)量評分,對兩組CTDIvol值、DL P值、圖像噪聲、及圖像質(zhì)量評分均值用t檢驗進行比較。評價低劑量螺旋CT三維重建的臨床價值。 結(jié)果：兩組的CTDIvol值分別為(9.6)和(2.4)mGy,DLP值分別為(156.60±4.30)和(25.40±7.99)mGy. cm,低劑量組較常規(guī)組下降約(61.68)%,兩者之間差異均有統(tǒng)計學(xué)意義(P0.05),低劑量組噪聲均值略高于常規(guī)組(分別為11.36±2.95和16.42±2.96),t=-7.199,P=0.000,但兩組圖像質(zhì)量平均評分分別為(4.85±0.41)分和(4.81±0.44)分,差異無統(tǒng)計學(xué)意義(t=0.465,P0.05)。通過30例患兒隨訪2年觀察考核指標(biāo),證實利用低劑量螺旋CT三維重建技術(shù)可對骨骺損傷的準(zhǔn)確分型,有效輔助臨床診療,治療效果滿意。 結(jié)論：低劑量螺旋CT三維重建技術(shù)可降低輻射劑量且所得圖像質(zhì)量不影響診斷,可對骨骺損傷的準(zhǔn)確分型,輔助臨床診療,對患兒創(chuàng)傷更小,具有較高臨床價值。
[Abstract]:Objective: to investigate the clinical value of low dose spiral CT 3D reconstruction in early diagnosis and classification of epiphyseal injury and its influence on image quality. Methods: thirty cases of epiphyseal injury in children under 16 years of age were randomly selected. Common X-ray films and low dose spiral CT were used to reconstruct epiphyseal injury in early stage, to determine the type of epiphyseal injury and to guide the clinical selection of corresponding treatment measures. The occurrence rate of bone bridge, premature closure of epiphysis and deformity of limb joint were observed after 2 years follow-up. Three dimensional reconstruction images of low dose spiral CT were divided into two groups, 30 cases in both groups. The obtained images were evaluated by double blind method. The CTDIvol value, DL P value and image noise were evaluated. And the mean value of image quality score was compared with t test. To evaluate the clinical value of three-dimensional reconstruction of low-dose spiral CT. Results: the CTDIvol values of the two groups were (156.60 鹵4.30) and (25.40 鹵7.99) mGy.cm, respectively. The low dose group was lower than the conventional group (61.68), the difference was statistically significant (P0.05). The mean noise of the low dose group was slightly higher than that of the conventional group (11.36 鹵2.95 and 16.42 鹵2.96), but the mean value of noise in the low dose group was slightly higher than that in the conventional group (11.36 鹵2.95 and 16.42 鹵2.96) respectively. The average score of image quality in the two groups was (4.85 鹵0.41) and (4.81 鹵0.44), respectively. The difference was not statistically significant (P 0.05). 30 children were followed up for 2 years. The results showed that the low dose spiral CT 3D reconstruction technique could be used to classify epiphyseal injury accurately and effectively assist clinical diagnosis and treatment. The therapeutic effect was satisfactory. Conclusion: low dose spiral CT 3D reconstruction technique can reduce the radiation dose and the image quality does not affect the diagnosis of epiphyseal injury. It can be used for accurate classification of epiphyseal injury and assist clinical diagnosis and treatment. It is less invasive and has higher clinical value.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R816.8

【參考文獻】

相關(guān)期刊論文 前10條

1 周志強;葉崇云;魯開文;;螺旋CT三維重建解體膝關(guān)節(jié)保留脛骨在平臺骨折中的應(yīng)用[J];中國CT和MRI雜志;2007年02期

2 蔡成仕;趙瑞華;劉長春;劉英峰;孫延春;;16層螺旋CT及后處理技術(shù)對DR檢查可疑骨折的診斷價值[J];中國CT和MRI雜志;2008年01期

3 林飛飛;干蕓根;曾洪武;趙彩蕾;孫龍偉;杜喜峰;;螺旋CT低劑量掃描對小兒肘關(guān)節(jié)外傷的診斷價值[J];中國CT和MRI雜志;2010年03期

4 洪加源;練克儉;郭林新;林達生;丁真奇;康兩期;林斌;翟文亮;;跨骨骺滑動鋼板固定治療青少年股骨髁上A3型骨折[J];中國骨與關(guān)節(jié)損傷雜志;2011年04期

5 曾萬文;竹曉雷;孫木水;孔繁杰;夏建章;鐘浩鵬;楊德根;;兒童骺軟骨骨折X線、MRI影像診斷[J];嶺南現(xiàn)代臨床外科;2011年02期

6 干蕓根;孫潔;李蔭太;林飛飛;榮遠新;謝娜;向葵;徐大勇;;低劑量螺旋CT掃描及后處理對小兒氣管支氣管異物的診斷價值[J];中國臨床醫(yī)學(xué)影像雜志;2006年S1期

7 王兆紅;戴維享;吳德惠;;青少年股骨髁部骨骺損傷的手術(shù)治療[J];實用骨科雜志;2008年07期

8 徐壽良,俞逵侖,史新平,姚潔,邢偉;膝關(guān)節(jié)軟骨MR成像的技術(shù)探討[J];實用放射學(xué)雜志;2005年10期

9 廖士平;周建生;;骺板組織工程種子細胞的研究進展[J];中華全科醫(yī)學(xué);2011年05期

10 蔣兆貫;顧光官;劉棟;孟祥鴻;張涌;沈娟;;多層螺旋CT多種成像方法在脛骨平臺骨折中的診斷價值[J];蘇州大學(xué)學(xué)報(醫(yī)學(xué)版);2008年05期

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