摘要
目的:探讨能谱CT在钛笼椎间植骨融合评估中的应用价值。方法:对28例脊柱钛笼椎间植骨融合术后患者行能谱CT扫描,扫描后获得常规混合能量图像(Mixed)及110 keV单能图像(GSI)。在工作站测量Mixed图像及GSI图像的噪声(SD)及信噪比(SNR)。由两位不同年资放射科医师使用5分法分别对同一患者的Mixed和GSI图像的伪影大小及植骨显示的清晰度进行评分,并分别根据Brantigan-Steffee-Fraser(BSF)分级法对钛笼内植骨融合情况进行分级。结果:两位评分者的评分一致性较好(ICC>0.60)。相对于Mixed图像,GSI图像噪声减低(t=15.292,P<0.001),SNR增加(t=-7.749,P<0.001)。每一位评分者对GSI图像与Mixed图像的伪影评分之间、植骨清晰程度评分之间差异均具有统计学意义(P均<0.001)。虽然GSI图像与Mixed图像的BSF分级差异没有统计学意义(Reader 1:Z=-1.633,P=0.102>0.05;Reader2:Z=-1.342,P=0.180>0.05),但有两位患者的BSF评分在使用GSI图像后发生了变化。结论:GSI可有效减少噪声及金属伪影,提高图像质量,使得钛笼内植骨显示更清晰,有利于评估钛笼内椎间植骨融合情况。
Objective:To explore the value of GSI(Gemstone Spectral Imaging)in assessing of the fusion of intervertebral titanium cage.Methods:Twenty-eight patients who received intervertebral fusion using cages made of titanium were scanned by spectrum CT in this prospective study.Two sets of CT images,Mixed and monoenergy level(110keV GSI),were reconstructed for each patient.Image noise and signal-to-noise ratio(SNR)were measured on the workstation.Two radiologists used the 5-point scale to assess the artifacts and clarity of the bone graft respectively.The fusion status of grafts in titanium cage was scored according to Brantigan-Steffe-Fraser(BSF)grading methods.Results:The intra-observer variability was considered as substantial(ICC>0.6).Compared to Mixed images,the image noise reduced markedly(P<0.001)and the SNR increased(P<0.001)on GSI image.For each of the two readers,there was a significant difference(all P<0.001)between the GSI and Mixed images,and the artifacts and image quality assessing.Although there was no statistically significant difference in BSF grading between GSI and Mixed images(Reader 1:Z=-1.633,P=0.102;Reader 2:Z=-1.342,P=0.180>0.05).It is worthwhile to point that there were two patients whose BSF scores were different between Mixed and GSI images.Conclusion:GSI can significantly reduce the metal artifacts and display better details of the intervertebral titanium cage fusion.
作者
孙才渊
王凤丹
张燕
薛华丹
金征宇
SUN Cai-yuan;WANG Feng-dan;ZHANG Yan(Department of Radiology,Peking Union Medical College Hospital,Chinese Academy Medical Sciences and Peking Union Medical College,Beijing 100730,China)
出处
《放射学实践》
CSCD
北大核心
2021年第3期383-387,共5页
Radiologic Practice
关键词
能谱CT
金属伪影
钛笼
椎间植骨融合
Energy spectrum CT
Metal artifcats
Cage
Intervertebral fusion
