定量CT骨构筑学研究

Constructional analyses of vertebral trabecula by QCT

目的 通过对人体椎体骨二维和三维的CT测量和研究,以期能获得对骨构筑学提供有价值的参数,提高骨质疏松诊断的准确性以及骨质疏松症骨折发生的预测。方法 随机抽取2000.4-2002.3间的49例患者(男10例,女39例),分别被作了SEQCT椎体的骨密度测量和L3椎体的高分辨率螺旋CT扫描(Somatom Plus,Siemens AG,Germeny)。骨密度的测定采用CT机附带软件程序,按照国人的标准计算确定,并作了两种体模的检查方法换算。二维图像分析将CT图像转换成黑白二值化后,采用同济大学的太阳图像分析系统TJTY-300V1.0版本进行了分析计算。三维图像的处理采用了CT机的三维图像处理软件程序,主要使用表面阴影显示法(SSD)对选定的病例分成两个年龄组进行比较观察。所有的数据均采用了统计学方法作了处理。 结果 两种体模转换方法的CT值之间无显著差异(p<0.01);二维图像分析的结果有如下的变化:1.年龄变化对骨小梁形态学参数产生影响,2.骨小梁形态学的相关参数与BMD密切相关,3.椎体上中下三平面显示特征性的变化。椎体骨微细结构三维图像观察分别产生:1.椎体小梁骨结构的数量变化,2.形态学变化,3.和连接性变化。结论 根据本文作出的换算公式,可在两种不同的体模之间方便地进行转换(转换因子0.95)。根据骨质疏松的发展水平。

Objective By using CT scan to vertebral trabecula to image pictures in two and/or three dimenstion, in order to obtain some usful information in osteoporostic diagnosis and construction of vertebral trabecula, and improve a veracity to the diagnosis of osteoporosis and prognosticate the occurring of fracture in osteoporostic patients. Methods Fourty-nine patients (10 males, 39 females) randomly selected during Apr. 2000- Mar.2002 were performed QCT(Somatom Plus,Siemens AG, Germeny)of the vertebral bodies and undergone simultaneously high resolution spiral CT of the L3 vertebral body. The analysis of BMD was performed with an analytical programe of CT scanner, and a conversion of data between 2 different phantoms was made according to Chinese standard. An image analytical system (TJTY-300V 1.0) of the Tongji University was used as 2 dimensional image analysis after which had been made B/W conversion. 3 dimensional reformation of CT images was undergone with a surface shade display (SSD) algorithme depending on 2 different age groups, and a comparison was made between these 2 age groups. All the data of above were analyzed in statistics. Results There was no significant difference (p<0.01) of CT number between 2 different phantoms when the conversion was made. Computer-assisterd 2-D image analysis has concluded as follow: 1. An increase of age has an impact on morphology of trabeculae; 2. Morphologic parameter of trabeculae is closely related to BMD; 3. Three transverse sections of vertebral body from top to bottom have showed a characteristic change. 3-D image comparison of vertebral micro-architecture has come to: 1. Trabeculae configuration quantity of vertebral body changed; 2. Morphology of trabeculae configuration changed; 3. Connectivity of trabeculae configuration changed. Conclusions Datum from different 2 phantoms can be converted after a conversion factor (0. 95) is applied. The trabeculae, which is sensitivity part of osterporosis, can bring on a changeful, trabeculae configuration change owing to the osteoporosis sever or not.