三维CT扫描评价股骨滑车发育不良的应用研究

发布时间：2018-07-22 10:52

【摘要】：目的:评估膝关节三维CT扫描结合MIMICS图像分析系统与X线平片在评价股骨滑车发育不良中的差异及其临床应用价值。方法:2013年5月至2014年1月,连续30例诊断为复发性髌骨脱位患者接受手术治疗。患者术前均接受膝关节三维CT扫描,采用MIMICS图像分析系统进行处理并计算股骨滑车突起指数。患者术前接受膝关节X线透视检查,获得纯侧位X线片,测量股骨滑车突起指数。对比两种评估方法结果的差异。以X线片测量方法为标准,计算三维CT分析方法的敏感性、特异性、阳性预测值以及阴性预测值。结果:30例患者采用膝关节侧位X线片方法评价股骨滑车突起指数均值为5.3±1.8 mm(3.2至8.4 mm)。膝关节三维CT扫描评价股骨滑车突起指数平均为5.2±1.5 mm(3.5至8.1mm)。两种测量方法结果的差异无统计学意义(P=0.8460.05)。以X线片方法为标准,三维CT评估方法的敏感性、特异性、阳性预测值以及阴性预测值分别为89.5%、81.8%、89.4%、82.0%。结论:膝关节三维CT扫描评估股骨滑车发育不良能够获得良好的敏感性、特异性。与膝关节侧位X线片评估方法所得结果无显著差异。CT影像技术能够提供更简便、安全的评估途径。
[Abstract]:Objective: to evaluate the difference and clinical value of 3D CT scan combined with mimics image analysis system and X-ray plain film in the evaluation of femoral trochlear dysplasia. Methods: from May 2013 to January 2014, 30 consecutive patients with recurrent patellar dislocation underwent surgical treatment. All the patients underwent 3 D CT scan before operation, and MIMICS image analysis system was used to process and calculate the femoral trochlear protuberance index. X-ray examination of knee joint was performed before operation, and lateral X-ray films were obtained to measure the femoral trochlear protuberance index. Compare the results of the two evaluation methods. The sensitivity, specificity, positive predictive value and negative predictive value of three-dimensional CT analysis were calculated according to X-ray measurement method. Results the average index of femoral trochlear process was 5.3 卤1.8mm (3.2-8.4 mm).) in 30 cases of femur with lateral radiography of knee joint. The average index of femoral trochlear process was 5.2 卤1.5 mm (3.5 to 8.1mm) on 3D CT scan of knee joint. There was no significant difference between the two methods (P < 0. 846. 05). The sensitivity, specificity, positive predictive value and negative predictive value of 3D CT were 89.58.81.8and 89.40.The sensitivity, specificity, positive predictive value and negative predictive value were 82.0 and 82.0, respectively. Conclusion: 3 D CT scan of knee joint can obtain good sensitivity and specificity in evaluating femoral trochlear dysplasia. There was no significant difference between the results of lateral radiography and knee joint lateral radiography. Ct imaging technique could provide a more convenient and safe way to evaluate the knee joint.
【作者单位】：河北省承德县医院外三科;北京积水潭医院运动损伤科;
【分类号】：R816.8;R681.1

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