低剂量螺旋CT三维重建在骨骺损伤早期诊断分型中的临床价值研究

发布时间：2018-07-14 08:56

【摘要】：目的：通过研究低剂量螺旋CT三维重建在骨骺损伤早期诊断分型中的临床作用,来探讨低剂量螺旋CT三维重建的临床价值和其对图像质量的影响,从而进一步指导临床治疗。方法：随机选择16岁以下儿童骨骺损伤病例30例,早期选择普通X线摄片和低剂量螺旋CT三维重建,确定骨骺损伤类型,指导临床选择相应的治疗措施,随访2年观察肢体骺板出现骨桥和骺早闭以及肢体关节发育畸形的出现率。将低剂量螺旋CT三维重建图像与既往相关病例中常规剂量图像分为两组,两组均为30例,获得的图像通过双盲法进行质量评分,对两组CTDIvol值、DL P值、图像噪声、及图像质量评分均值用t检验进行比较。评价低剂量螺旋CT三维重建的临床价值。结果：两组的CTDIvol值分别为(9.6)和(2.4)mGy,DLP值分别为(156.60±4.30)和(25.40±7.99)mGy. cm,低剂量组较常规组下降约(61.68)%,两者之间差异均有统计学意义(P0.05),低剂量组噪声均值略高于常规组(分别为11.36±2.95和16.42±2.96),t=-7.199,P=0.000,但两组图像质量平均评分分别为(4.85±0.41)分和(4.81±0.44)分,差异无统计学意义(t=0.465,P0.05)。通过30例患儿随访2年观察考核指标,证实利用低剂量螺旋CT三维重建技术可对骨骺损伤的准确分型,有效辅助临床诊疗,治疗效果满意。结论：低剂量螺旋CT三维重建技术可降低辐射剂量且所得图像质量不影响诊断,可对骨骺损伤的准确分型,辅助临床诊疗,对患儿创伤更小,具有较高临床价值。
[Abstract]:Objective: to investigate the clinical value of low dose spiral CT 3D reconstruction in early diagnosis and classification of epiphyseal injury and its influence on image quality. Methods: thirty cases of epiphyseal injury in children under 16 years of age were randomly selected. Common X-ray films and low dose spiral CT were used to reconstruct epiphyseal injury in early stage, to determine the type of epiphyseal injury and to guide the clinical selection of corresponding treatment measures. The occurrence rate of bone bridge, premature closure of epiphysis and deformity of limb joint were observed after 2 years follow-up. Three dimensional reconstruction images of low dose spiral CT were divided into two groups, 30 cases in both groups. The obtained images were evaluated by double blind method. The CTDIvol value, DL P value and image noise were evaluated. And the mean value of image quality score was compared with t test. To evaluate the clinical value of three-dimensional reconstruction of low-dose spiral CT. Results: the CTDIvol values of the two groups were (156.60 卤4.30) and (25.40 卤7.99) mGy.cm, respectively. The low dose group was lower than the conventional group (61.68), the difference was statistically significant (P0.05). The mean noise of the low dose group was slightly higher than that of the conventional group (11.36 卤2.95 and 16.42 卤2.96), but the mean value of noise in the low dose group was slightly higher than that in the conventional group (11.36 卤2.95 and 16.42 卤2.96) respectively. The average score of image quality in the two groups was (4.85 卤0.41) and (4.81 卤0.44), respectively. The difference was not statistically significant (P 0.05). 30 children were followed up for 2 years. The results showed that the low dose spiral CT 3D reconstruction technique could be used to classify epiphyseal injury accurately and effectively assist clinical diagnosis and treatment. The therapeutic effect was satisfactory. Conclusion: low dose spiral CT 3D reconstruction technique can reduce the radiation dose and the image quality does not affect the diagnosis of epiphyseal injury. It can be used for accurate classification of epiphyseal injury and assist clinical diagnosis and treatment. It is less invasive and has higher clinical value.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8

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