CT多平面重建术前评估枢椎椎弓根螺钉植入入路的可行性

发布时间：2018-04-27 17:51

本文选题：枢椎 + 椎弓根　；参考：《中国医学影像技术》2017年06期

【摘要】：目的通过CT MPR评估后路枢椎椎弓根螺钉植入(C2PSP)入路的可行性。方法对250例(500侧)患者头颈部CTA扫描数据行MPR,测量骨参数椎弓根直径(D)、椎弓峡部厚度(T)、内侧高度(H),动脉参数枢椎段椎动脉(IAVA)走行偏移方向[外侧(L)、垂直(N)、内侧(M)];IAVA骑跨程度[下方(b)、之间(w)、上方(a)]。计算椎弓根狭窄、高骑动脉(HRVA)和IAVA分型发生率,并分析椎弓根狭窄、HRVA、IAVA分型及枢椎椎动脉沟(C2VAG)损伤的关系。结果椎弓根狭窄和HRVA分别为14.40%(72/500)和24.60%(123/500),差异有统计学意义(χ2=141.984,P0.001)。模拟C2PSP损伤C2VAG的发生率为19.40%(97/500)。椎弓根狭窄和HRVA患者中模拟C2PSP损伤C2VAG的发生率高于无椎弓根狭窄和无HRVA患者(P均0.001)。椎弓根狭窄与HRVA同时伴发58侧(58/500,11.60%)。椎弓根狭窄、HRVA及C2VAG损伤在IAVA各型中发病率差异有统计学意义(P均0.001),均以M-a型最多,分别为55.56%(40/72)、46.34%(57/123)、48.45%(47/97)。结论 C2VAG损伤多发于椎弓根狭窄、HRVA或IAVA M-a型的患者;MPR可综合评估骨性和动脉参数,为C2PSP提供解剖学依据。
[Abstract]:Objective to evaluate the feasibility of posterior pedicle screw implantation via CT MPR. Methods the CTA scan data of the head and neck of 250 patients were performed. The pedicle diameter, the thickness of pedicle isthmus, the medial height and the axial vertebral artery were measured. Ride across [at the bottom, between wo, and above]. The incidence of pedicle stenosis, high riding artery (HRVA) and IAVA classification were calculated, and the relationship between HRVAVA classification and C2VAGI injury of pedicle stenosis was analyzed. Results the pedicle stenosis and HRVA were 14.40 / 500 and 24.600.123 / 500, respectively. The difference was statistically significant (蠂 2 / 141.984 / P 0.001). The incidence of simulated C2PSP damage to C2VAG was 19.40 / 97 / 500. The incidence of simulated C2PSP injury C2VAG in patients with pedicle stenosis and HRVA was higher than that in patients without pedicle stenosis and HRVA (P 0.001). Pedicle stenosis and HRVA were accompanied by 58 sides of 58 / 500 and 11.60%. There were significant differences in the incidence of HRVA and C2VAG injury in all types of IAVA. M-a type was the most common type, which was 55.56%, 46.34%, 48.45%, 48.45% and 47 / 97%, respectively55.56%, 46.34%, 46.34%, 48.45%, 48.45%, 48.45%, and 55.56%, 46.34%, 46.34%, 48.45%, respectively. Conclusion C2VAG injury mainly in patients with pedicle stenosis or IAVA M-a type can be used to evaluate the bone and artery parameters and provide anatomical basis for C2PSP. [WT5HZ] [WT5HZ] [WT5 "BZ] [WT5" BZ] [WT5BZ]
【作者单位】：重庆医科大学附属大学城医院放射科;重庆医科大学附属大学城医院骨科;
【基金】：重庆市卫生计生委医学科研项目(2016MSXM059)
【分类号】：R687.3;R816.8

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