双源CT在膝关节交叉韧带损伤成像中的应用评价

发布时间：2018-03-13 06:20

本文选题：双源CT　切入点：容积成像　出处：《青海大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的运用双源CT多平面重建、容积成像及双能量成像等技术，与关节镜对照，分析交叉韧带损伤的诊断符合率及交叉韧带损伤术前和术后影像特点。方法收集2012年3月-2013年3月期间有单侧膝关节外伤史，并经临床检查，诊断为疑似交叉韧带损伤的患者35例。采用双源CT对所有术前和部分术后病例行双膝关节双能量容积扫描。通过后处理工作站对所得数据进行多平面重建、容积成像及双能图像处理，对双侧交叉韧带CT值（Hu）、长度（mm）及起始段（mm）、中段（mm）和末段（mm）的厚度进行测量，并对交叉韧带损伤进行诊断，明确交叉韧带有无损伤。35例患者均进行关节镜检查。对所得数值进行统计学分析。结果1.CT诊断结果与关节镜检查结果比较，阳性诊断率为74.3%。2.患侧交叉韧带CT值均比正常侧不同程度降低，最大差值26Hu，最小差值2Hu；起始段增厚14例，中段增厚11例；末段增厚6例。3.关节镜确诊为损伤的有30例；右侧19例，左侧11例；前交叉韧带23例，后交叉韧带6例，前后交叉韧带同时损伤1例；起始段14例，中段11例，末段6例；完全断裂9例，部分断裂22例；单纯韧带损伤8例，合并半月板等其他损伤23例；交叉韧带正常5例，均为半月板损伤。4.两种检查方法X2=0.8，P＞0.05，无统计学意义，Kappa值为0.646；正常侧与患侧CT值、起始段、中段厚度和后交叉韧带配对分析，差别具有统计学意义（P＜0.05）；前交叉韧带长度和末段厚度，，差别无统计意义（P＞0.05）。5.双能肌腱韧带模式图像，对交叉韧带形态、走行显示较好，对交叉韧带损伤诊断符合率约为86.7%。6.交叉韧带损伤术后图像，对骨隧道显示清晰。结论1.双源CT容积成像对膝关节交叉韧带损伤诊断具有一定临床价值；2.双源CT能够通过测量交叉韧带的CT值和起始段、中段的厚度对部分损伤进行评价。3.重建图像对术后韧带显示有限，但对骨隧道显示效果较好。
[Abstract]:Objective to compare dual-source CT multiplanar reconstruction, volumetric imaging and dual-energy imaging with arthroscopy. To analyze the diagnostic coincidence rate of cruciate ligament injury and the imaging features before and after cruciate ligament injury. Methods A history of unilateral knee joint injury was collected from March 2012 to March 2013. Thirty-five patients were diagnosed as suspected cruciate ligament injury. Dual source CT scanning was performed on all patients before and after operation. The data were reconstructed by multiplanar reconstruction with postprocessing workstation. Volume imaging and dual-energy image processing were performed to measure the thickness of bilateral cruciate ligament (CT) and the initial, middle and end segments of cruciate ligament, and to diagnose the injury of cruciate ligament. All 35 patients with cruciate ligament injury were examined by arthroscopy. The results were statistically analyzed. 1. The results of CT diagnosis were compared with those of arthroscopy. The positive diagnosis rate was 74.3.2. the CT value of the affected cruciate ligament was lower than that of the normal side in varying degrees, the maximum difference value was 26Hu, the minimum difference value was 2Hu. the initial segment thickened in 14 cases, the middle segment thickened in 11 cases, the last segment thickened in 6 cases .3.The arthroscopy confirmed the injury in 30 cases, the right side in 19 cases. Left 11 cases, anterior cruciate ligament 23 cases, posterior cruciate ligament 6 cases, anterior cruciate ligament 1 case, initial 14 cases, middle 11 cases, end 6 cases, complete rupture 9 cases, partial rupture 22 cases, simple ligament injury 8 cases. There were 23 cases with meniscus and other injuries, 5 cases with normal cruciate ligament, and 4 cases with meniscus injury. The two methods of examination were X _ (2) O _ (0.8) P > 0.05, no significant Kappa value was 0.646, CT value of normal side and affected side, initial segment, middle segment thickness and posterior cruciate ligament were analyzed. The difference was statistically significant (P < 0.05), the length and thickness of anterior cruciate ligament were not statistically significant (P > 0.05). The diagnostic coincidence rate of cruciate ligament injury was about 86.7%. Conclusion: Dual-source CT volumetric imaging has certain clinical value in the diagnosis of cruciate ligament injury of knee joint 2.Dual-source CT can measure the CT value and initial segment of cruciate ligament. The thickness of the middle segment was used to evaluate the partial injury. 3. The reconstruction image was limited in displaying the postoperative ligament, but it was better for the bone tunnel.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8

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