特发性脊柱侧弯胸主动脉与相邻椎体空间关系的CT测量

CT Measurement of the Spatial Relationship between Aorta and Neighboring Thoracic Vertebral Body in Idiopathic Scoliosis

目的:利用螺旋CT测量特发性脊柱侧弯胸主动脉与相邻椎体的空间关系。材料和方法:32例特发性胸椎侧弯者,在T4～12 椎体平面的CT图像上作双侧肋骨小头前缘连线l,l与椎体右缘交点至主动脉后壁的切线m ,测量l与m的夹角A ;当A <0时,即l穿过主动脉,沿l测量椎体与主动脉的距离d ,将A和d作为主动脉和椎体空间关系的参数,评价脊柱侧弯前路矫形术的安全性。结果:当A >0时,椎体与主动脉空间关系被定义为“安全”( 2 1 1 ,74 .6 % ) ;当A <0 ,d >2mm时,被定义为“可疑”( 4 5,1 5.9% ) ;当A <0 ,d <2mm时,被定义为“危险”( 2 7,9.5% )。结论:CT测量可以准确描述脊柱侧弯者胸主动脉与相邻椎体的空间关系,为前路矫形术椎体螺钉的安全置入提供参考。

Purpose: To measure the spatial relationship between the vertebral body and the thoracic aorta in idiopathic scoliosis with spiral CT. Materials and Methods : 32 patients with thoracic scoliosis were examined. On CT axial images from T4 to T12, line l was drawn through the anterior edge of the bilateral rib heads, line m was drawn tangent the posterior edge of the aorta and passing through the intersection of the right edge of the vertebral body and line l. The angle A between line l and line m was measured for evaluation. If A<0, which means that l passing through the aorta, the distance d between the aorta and vertebral body along line l were measured. Both A and d were used as the parameters for evaluating the safety of the anterior instrumentation surgery for scoliosis. Results: When A>0,the spatial relationship between the vertebrae and aorta was defined as ' safe' (211, 74.6%). When A<0 and d>2mm, it was defined as 'suspicious'(45,15.9%). When A<0,d<2mm, it was defined as 'dangerous'(27,9.5%). Conclusion: CT Measurement can exactly describe the spatial relationship between the vertebral body and the thoracic aorta in idiopathic scoliosis and provide reference for precise and safe screw implanting in the anterior instrumentation surgery for scoliosis.