摘要
目的通过采用多层螺旋CT扫描及三维重建技术测量肋软骨形态学参数并评价测量结果的准确性,探讨该技术在肋软骨组织量评估中的应用价值。方法以2013年3月-8月拟接受八大处法耳廓再造术的75例先天性小耳畸形患者作为实验对象,其中男49例,女26例;年龄5岁7个月-32岁7个月,平均8岁5个月。体重21-82kg,平均29.5kg。根据患者年龄、体重选择扫描参数,采用64排螺旋CT机扫描双侧第1-12肋,最大密度投影（maximum intensity projection,MIP）及容积重建技术（volume rendering technique,VRT）三维重建肋骨及肋软骨图像;观察VRT图像中肋软骨形态,测量MIP图像中肋软骨近肋骨处宽度（W）及肋软骨全长（L）。于术中取肋软骨后即刻测量肋软骨近肋骨处宽度（W’）及肋软骨全长（L’）。比较CT及实际测量结果,分析结果一致性。结果 VRT图像显示肋骨及肋软骨形态清晰、逼真,立体感强。共测量手术相关的192根肋软骨。肋软骨近肋骨处宽度W为（9.69±1.67）mm,W’为（9.73±1.64）mm,比较差异无统计学意义（t=—1.800,P=0.073）;组内相关系数（interclass correlation coeffi cient,ICC）检验示Cronbach’sα=0.993。肋软骨全长L为（83.03±23.86）mm,L’为（81.83±16.43）mm,比较差异无统计学意义（t=1.367,P=0.173）;ICC检验示Cronbach’sα=0.904;线性回归分析示L=1.28×L’-21.93（R2=0.780,F=673.427,P=0.000）。CT测量值与实际值一致性较好。结论根据患者年龄、体重选择合适扫描参数,经测量MIP三维重建图像获得的肋软骨宽度、长度与实际值符合度达95%以上,且图像所示长度与实际值满足线性回归,能够较为精确地判断肋软骨组织量,配合VRT三维重建技术得到的肋软骨形态学图像,可为整形外科临床应用提供准确参考。
Objective To investigate the accuracy of multi-slice spiral CT（MSCT） scan and image reconstruction technology for measuring morphological parameters of costal cartilages and to evaluate the volume of costal cartilages. Methods Between March and August 2013, 75 patients with congenital microtia and scheduled for auricle reconstruction were included in the study. Of 75 patients, there were 49 males and 26 females with a mean age of 8 years and 5 months（range, 5 years and 7 months to 32 years and 7 months） and a mean weight of 29.5 kg（range, 21-82 kg）. A Philips Brilliance 64 MSCT machine was used to scan 1st-12 th costal cartilages with the parameters based on the age and weight of the patients. All the data were transported to the workstation for reconstructing the image of the costal cartilages with the technique of maximum intensity projection（MIP） and volume rendering technique（VRT）. Then the morphologies of costal cartilages were observed through the images on VRT; the width of the costal cartilaginous ends close to ribs（W） and the length of the total cartilage（L） were measured and compared with their counterparts（W＇ and L＇） after the costal cartilages were harvested during the processes of auricle reconstructions to analyze consistency between these two sets of data. Results The morphologies of ribs and costal cartilages shown on VRT image got fine sharpness, verisimilitude, and stereoscopic impressions. A total of 192 costal cartilages were examined. The results showed that the widths of the costal cartilaginous ends close to ribs（W） was（9.69 ± 1.67） mm, and W＇ was（9.73 ± 1.64） mm, showing no significant difference between W and W＇（t= —1.800, P=0.073）, and interclass correlation coefficient（ICC） test showed Cronbach＇s α=0.993. The length of the total cartilage（L） was（83.03 ± 23.86） mm, and L＇ was（81.83 ± 16.43） mm, showing no significant difference between L and L＇（t=1.367, P=0.173）, and ICC test showed Cronbach＇s α=0.904. Linear-regression analysis showed L=1.28 × L＇- 21.93（R2=0.780, F=673.427, P=0.000）. The results suggested there was a good consistency between these two sets of data. Conclusion Scanning costal cartilages with appropriate parameters and reconstructing the cartilaginous image with MIP is an effective method to measure the width and length of costal cartilage and to estimate costal cartilage volume, which can provide accurate reference for plastic surgery together with reading the morphology from the image on VRT.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2014年第10期1266-1269,共4页
Chinese Journal of Reparative and Reconstructive Surgery
基金
北京市科技计划项目"首都临床特色应用研究"(Z121107001012111)
中国医学科学院整形外科医院(研究所)院所基金重大项目~~
关键词
多层螺旋CT
图像三维重建
肋软骨
小耳畸形
Multi-slice spiral CT
Image reconstruction
Costal cartilage
Microtia
