Ⅰ型神经纤维瘤病性脊柱侧凸畸形中256层螺旋CT的术后形态学评估研究

发布时间：2018-03-17 06:05

本文选题：256层螺旋CT　切入点：营养不良　出处：《吉林大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：通过256层螺旋CT的后处理技术，评价一期后路节段性椎弓根螺钉系统对营养不良型Ⅰ型神经纤维瘤病性脊柱侧凸畸形的临床治疗效果。主要是对椎弓根螺钉的形态及位置等情况进行了256层螺旋CT的检查以及后期重建处理，观察了植入的椎弓根螺钉的形态、位置等情况，进而从影像学的角度对手术方式进行影像学的评估。方法：对我院7例营养不良型Ⅰ型神经纤维瘤病性脊柱侧凸畸形的患者，共96枚椎弓根螺钉进行了256层螺旋CT的检查，运用了相应的后处理技术进行后期处理，对术后椎弓根螺钉置入的效果进行了评估。结果： 96枚螺钉全部位于椎弓根的范围内。32枚螺钉穿破了椎弓根的骨壁。椎弓根螺钉的穿透距离＜2mm的有23枚；椎弓根螺钉的穿透距离在2-4mm之间的有6枚；椎弓根螺钉的穿透距离＞4mm的有3枚。胸椎当中的椎弓根的螺钉穿透数目为24枚；腰椎当中的椎弓根的螺钉穿透率为7枚。对于显示术后疗效的效果上，，平面/曲面重建(MPR/CPR)技术可以从各个不同的角度来重新显示某一个畸形椎体的冠状位和失状位上的图像，相对而言是比较方便并且实用的后处理方法，容积漫游技术（VRT）的优势在于它可以进行一个全面的显示，对临床外科的治疗有很大的价值。结论：营养不良型Ⅰ型神经纤维瘤病性脊柱侧凸畸形在临床工作当中，相对于其他类型的脊柱侧凸畸形来说比较少见。本研究中的7例营养不良型Ⅰ型神经纤维瘤病性脊柱侧凸畸形的患者均进行了手术方式为“一期后路节段性椎弓根螺钉植入术”的系统治疗，我们对7例术后的患者进行了256层螺旋CT的检查以及后期重建处理，观察了植入的椎弓根螺钉的形态、位置等情况，进而从影像学的角度对手术方式进行评估。发现7例患者在接受一期后路节段性椎弓根螺钉植入术的系统治疗后的疗效较为满意，没有出现严重的并发症。在后处理技术中，平面/曲面重建(MPR/CPR)技术相对来讲是一种方便实用的后处理方法，而容积漫游技术（VRT）则可以进行一个整体的显示，从而对临床医师起到一个直观的提示作用。
[Abstract]:Objective:. Through the post processing technology of 256 slice spiral CT, To evaluate the clinical effect of one stage posterior segmental pedicle screw system in the treatment of dystrophy type I neurofibromatosis scoliosis, the 256-slice spiral was performed on the morphology and position of pedicle screw. Ct examination and post-reconstruction, The shape and position of pedicle screw implantation were observed, and the imaging evaluation of the operation was carried out from the point of view of imaging. Methods:. A total of 96 pedicle screws were examined by 256-slice spiral CT in 7 patients with dystrophy type I neurofibromatosis scoliosis in our hospital. The effect of pedicle screw implantation was evaluated. Results:. All the 96 screws were located within the range of pedicle pedicle. 32 screws pierced the bone wall of pedicle pedicle, 23 screws with penetration distance of less than 2 mm, 6 screws with penetration distance between 2 mm and 4 mm, and 6 screws with penetrating distance between 2 mm and 4 mm. The penetrating distance of pedicle screw was more than 4 mm. The number of pedicle screws in thoracic vertebrae was 24, and the penetration rate of pedicle screws in lumbar vertebrae was 7. The plane / surface reconstruction technique MPR-CPR can re-display the coronal and lost images of a deformed vertebral body from different angles, which is a relatively convenient and practical post-processing method. Volume roaming technique (VRT) has the advantage that it can perform a comprehensive display and is of great value for clinical surgical treatment. Conclusion:. Dystrophy type I neurofibromatosis scoliosis in clinical work, Compared with other types of scoliosis, 7 patients with dystrophy type I neurofibromatosis were operated on as one stage posterior segmental pedicle. "systematic treatment of root screw implantation," We performed 256-slice spiral CT examination and post-reconstruction in 7 patients after operation, and observed the shape and position of the pedicle screw implanted. From the perspective of imaging, it was found that 7 patients had satisfactory results after systematic treatment of one-stage posterior segmental pedicle screw implantation, with no serious complications. The plane / surface reconstruction MPR-CPR technique is a convenient and practical post-processing method, while the volumetric roaming technique (VRTT) can be displayed as a whole, thus providing an intuitionistic hint to clinicians.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8;R682.13

【参考文献】