CAJ | 학술논문

目的：探索双源CT单能谱成像技术在腰椎峡部裂术后去除金属内固定伪影的临床应用价值。方法24例腰椎峡部裂内固定术后患者,采用双源CT双能量模式扫描,应用单能谱技术(monoenergetic)及3D、Inspace软件进行后处理,分别获得50、80、110、140、170 keV 5组图像及在相应条件下和平均加权120 keV 条件下的多平面重建(multi-planar reconstruction,MPR)、容积再现(volume rendering,VR)及最大密度投影(maximum intensity proj ection,MIP)图像。由2名高年资放射科医师对这5组图像及平均加权120 keV图像进行图像质量评分,对图像质量评分采用Kruskal-Wallis 检验进行统计学分析。由2名高年资骨科医师对最佳 keV条件下 MPR、VR及 MIP图像的临床价值进行评价。对2名放射科及骨科医师的评分结果进行Kappa检查,评价一致性。结果在所有患者中,110 keV图像3分以上为24例,80 keV图像3分以上为14例,140 keV图像3分以上为13例,平均加权120 keV图像3分以上为8例。单能谱110 keV图像能够提供最佳质量的图像(F值为98.523,P<0.01)。在110 keV条件下重建 MPR、VR、MIP图像,图像质量优秀并具有较高临床价值达到86.1%,其中 MPR图像达到100%。结论双源 CT单能谱成像技术在腰椎峡部裂术后去除金属内固定伪影具有较高的临床价值,在110 keV条件下图像质量最佳,利用 MPR技术重建图像具有最高临床应用价值。
목적：탐색쌍원CT단능보성상기술재요추협부렬술후거제금속내고정위영적림상응용개치。방법24례요추협부렬내고정술후환자,채용쌍원CT쌍능량모식소묘,응용단능보기술(monoenergetic)급3D、Inspace연건진행후처리,분별획득50、80、110、140、170 keV 5조도상급재상응조건하화평균가권120 keV 조건하적다평면중건(multi-planar reconstruction,MPR)、용적재현(volume rendering,VR)급최대밀도투영(maximum intensity proj ection,MIP)도상。유2명고년자방사과의사대저5조도상급평균가권120 keV도상진행도상질량평분,대도상질량평분채용Kruskal-Wallis 검험진행통계학분석。유2명고년자골과의사대최가 keV조건하 MPR、VR급 MIP도상적림상개치진행평개。대2명방사과급골과의사적평분결과진행Kappa검사,평개일치성。결과재소유환자중,110 keV도상3분이상위24례,80 keV도상3분이상위14례,140 keV도상3분이상위13례,평균가권120 keV도상3분이상위8례。단능보110 keV도상능구제공최가질량적도상(F치위98.523,P<0.01)。재110 keV조건하중건 MPR、VR、MIP도상,도상질량우수병구유교고림상개치체도86.1%,기중 MPR도상체도100%。결론쌍원 CT단능보성상기술재요추협부렬술후거제금속내고정위영구유교고적림상개치,재110 keV조건하도상질량최가,이용 MPR기술중건도상구유최고림상응용개치。
Objective To explore the clinical value of monoenergetic technology of dual-source CT in removing the artifact of me-tallic fixation after the operation of lumbar spondylolysis.Methods 24 cases of patients with metallic fixation after operation of lum-bar spondylolysis were scanned by dual-energy CT.To reconstruct the imaging using monoenergetic and 3D Inspace software,obtain 50,80,110,140,170 keV five groups of images and the multi-planar reconstruction*(MPR),volume vendering(VR),maximum intensity projection(MIP)imaging in different conditions.The five groups image and average weighted 120kev image are evaluate by two senior radiologist.The quality score of five groups of images and the average weighted images are analyzed statistically using Kruskal-Wallis test.The clinical value of images in the optimal condition are evaluated by two senior department of orthopedics phy-sicians.The results of two radiologists and department of orthopedics physician are examined by kappa test to evaluate consistency. Results In all patients after operation,the case of 110keV images above 3 points is 24,the case of 80keV images above 3 points is 14,the case of of 140keV images above 3 points is 13,the case of weighted average 120kev images above 3 points is 8.Images in 110keV have the best quality (F=98.523,P<0.01).MPR,VR,MIP images are reconstructed in 110keV.The ratio of image which are excellent and have high clinical value is 86.1%,especially the ratio of MPR image is 100%.Conclusion Monoenergetic technology of dual-source CT has a higher clinical value in removing the artifact of metallic fixation after the operation of lumbar spondylolysis.Under the condition of 110keV the quality of images are best,the reconstructed images using MPR Technology have the best clinical value.