多排螺旋CT在腰部肌群形态学的探讨研究

发布时间：2018-03-12 11:40

本文选题：下腰痛　切入点：横断面积　出处：《吉林大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：通过利用腰部多排螺旋CT扫描重建图像，对腰部肌群进行相关测量，提供出横断面积及CT值等影像资料，为临床腰部疾病诊断提供发病机制、干预作用等基本信息的依据。同时对男女不同年龄组人群进行比较，为腰部疾病的诊断、治疗和预防提供详实可靠的测量数据。方法：收集我院2010年9月至2011年4月间在吉林大学中日联谊医院放射科检查的240例腰部CT扫描图像重建（体检病人包括患下腰痛患者）在不同的腰椎横突水平测量腰大肌、腰方肌、竖脊肌横断面积和平均CT值等。其中20-29岁为A组、29-39岁为B组、39-49岁为C组、49-59岁为D组、59-69岁为E组、70-79岁为F组。每组40例患者（男20例、女20例）。检查前排除金属伪影干扰可能，嘱患者仰卧位平躺，放松、平静呼吸。本研究采用ToshibaActivion16排螺旋CT扫描仪器，，扫描参数：电压120kV、电流250mA、层厚1mm，层间距1mm容积扫描。应用Xiphoid软件进行数据测量及后处理，获取不同层水平腰部肌群的横断面积及CT值。采用SPSS16.0统计软件，分别求出平均数、标准差和P值等，并对各组进行方差分析，当P0.05时有统计学意义。结果：男性腰大肌横断面积平均值由A组到F组分别为14.18cm~2、14.18cm~2、13.92cm~2、11.66cm~2、11.11cm~2、10.32cm~2，平均CT值52.85HU、51.19HU、46.99HU、43.56HU、40.88HU、39.51HU。女性腰大肌横断面积平均值由A组到F组分别为7.54cm~2、8.20cm~2、8.16cm~2、8.18cm~2、7.59cm~2、7.06cm~2，平均CT值48.51HU、45.13HU、41.0~2HU、37.5~2HU、36.46HU、31.11HU。男性腰方肌横断面积平均值由A组到F组分别为13.40cm~2、13.53cm~2、13.33cm~2、11.17cm~2、10.57cm~2、9.73cm~2，平均CT值53.16HU、51.54HU、46.81HU、43.~25HU、40.65HU、39.36HU。女性腰方肌横断面积平均值由A组到F组分别为8.1~2cm~2、8.83cm~2、8.84cm~2、8.83cm~2、8.22cm~2、7.68cm~2，平均CT值48.71HU、45.33HU、40.97HU、37.18HU、36.17HU、31.09HU。男性竖脊肌横断面积平均值由A组到F组分别为16.93cm~2、16.81cm~2、16.57cm~2、13.78cm~2、13.33cm~2、12.52cm~2，平均CT值5~2.1HU、50.31HU、46.10HU、41.93HU、39.06HU、37.59HU。女性竖脊肌横断面积平均值由A组到F组分别为10.90cm~2、11.78cm~2、11.65cm~2、11.31cm~2、10.59cm~2、10.18cm~2，平均CT值47.42HU、44.34HU、39.9~2HU、35.47HU、33.41HU、~26.99HU。结论：通过对~240例图像重建分析，多排螺旋CT能清楚显示腰部肌群及邻近周围器官的解剖结构，并能对骨质密度有较好的分辨，但对竖脊肌的分区准确性稍差。相同性别的不同年龄组腰部肌群测量横断面积由于老化肌肉的纤维数量减少、脂肪沉积而呈下降趋势，在39-49岁年龄组变化趋势明显。相同年龄组的不同性别腰部肌群测量存在不同差异，男性肌肉横断面积略大于女性，且变化趋势亦不相同，女性下降曲线略早于男性。结合临床资料，椎体的稳定与腰部肌群息息相关，当出现生理曲度侧弯或滑脱时，两侧腰部肌群形态学往往发生了变化。腰部肌群横断面积及CT值等形态学参数，为临床诊断、干预治疗、康复锻炼等提供有力指导数据。
[Abstract]:Objective: through the use of the multi slice spiral CT reconstruction images of waist muscle groups for measurement, provide cross-sectional area and CT value of image data, provide mechanisms for clinical diagnosis of lumbar disease, intervention and other basic information basis. At the same time for men and women of different age groups were compared for the diagnosis of lumbar disease the treatment and prevention to provide detailed and reliable measurement data.
Methods: in our hospital from September 2010 to April 2011 in the Department of Radiology examination in China Japan Union Hospital of Jilin University in 240 cases of lumbar CT scan image reconstruction (including a medical examination of a patient with low back pain patients) in the lumbar vertebra waist level of different muscles, waist muscle, erector spinae muscle cross-sectional area and the average CT value of 20-29. At the age of 29-39 years for the A group, B group, 39-49 C group, 49-59 D group, 59-69 E group, 70-79 F group. Each group of 40 patients (male 20 cases, female 20 cases). Before the examination, exclude metal artifact, ask the patient to lie in a supine position. Relax, calm breathing. This study uses ToshibaActivion16 scan parameters: slice spiral CT scanning instrument, voltage 120kV, current 250mA, thickness 1mm, spacing 1mm volume scanning. Xiphoid software was used for data measurement and postprocessing, get a different level of waist muscle cross-sectional area and CT value. Using SPSS16.0 statistical software The average number, the standard deviation and the P value were calculated, and the variance analysis was carried out in each group. When P0.05 was statistically significant.
Results: male psoas muscle cross-sectional area average value from A group to F group were 14.18cm~2,14.18cm~2,13.92cm~2,11.66cm~2,11.11cm~2,10.32cm~2, the average CT value of 52.85HU, 51.19HU, 46.99HU, 43.56HU, 40.88HU, 39.51HU. female psoas muscle cross-sectional area average value from A group to F group were 7.54cm~2,8.20cm~2,8.16cm~2,8.18cm~2,7.59cm~2,7.06cm~2, the average CT value of 48.51HU, 45.13HU, 41.0~2HU, 37.5~2HU, 36.46HU 31.11HU., male waist muscle cross-sectional area average value from A group to F group were 13.40cm~2,13.53cm~2,13.33cm~2,11.17cm~2,10.57cm~2,9.73cm~2, average CT value of 53.16HU, 51.54HU, 46.81HU, 43.~25HU, 40.65HU, 39.36HU. female waist muscle cross-sectional area average value from A group to F group were 8.1~2cm~2,8.83cm~2,8.84cm~2,8.83cm~2,8.22cm~2,7.68cm~2, the average CT value of 48.71HU, 45.33HU, 40.97HU, 37.18HU. 36.17HU 31.09HU., male erector spinae muscle cross-sectional area average By the A group to F group were 16.93cm~2,16.81cm~2,16.57cm~2,13.78cm~2,13.33cm~2,12.52cm~2, the average CT value of 5~2.1HU, 50.31HU, 46.10HU, 41.93HU, 39.06HU, 37.59HU. female erector spinae muscle cross-sectional area average value from A group to F group were 10.90cm~2,11.78cm~2,11.65cm~2,11.31cm~ 2,10.59cm~2,10.18cm~2, the average CT value 47.42HU, 44.34HU, 39.9~2HU, 35.47HU, 33.41HU, ~26.99HU.. Conclusion: through the analysis of ~240 cases image reconstruction, multi slice spiral CT can clearly display the anatomical structure around the waist muscle groups and adjacent organs, and can have a better resolution on bone density, but the partition accuracy of erector spinae muscle after different age groups. Waist muscle groups of the same sex to measure cross-sectional area due to the number of aging muscle fibers reduced fat deposition a downward trend, in the 39-49 year old age group. There is an obvious trend of measuring different gender waist muscle groups of the same age groups Differences, male muscle cross-sectional area is slightly larger than the female, and the trend is not the same, the female decline curve slightly earlier than men. Combined with clinical data, the vertebral stability is closely related with the waist muscle groups, when the physiological curvature of scoliosis or spondylolisthesis, on both sides of the waist muscle morphology often changed. The morphological parameters of the waist muscle group cross-sectional area and CT value for clinical diagnosis, treatment, and rehabilitation exercise and provide strong guidance data.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.8

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