螺旋CT三维重建成像在先天性高肩胛症手术方式选择中的作用

Effect of three-dimensional computered tomographic reconstruction on operation choice of congenital elevation of the scapula

[目的]探讨螺旋CT三维重建技术在先天性高肩胛症分度和手术方式选择中的作用。[方法]22例先天性高肩胛症术前应用螺旋CT对病变部位进行扫描并三维重建，测量以肩胛骨肩胛冈内侧缘为参照点，两侧肩胛骨高度差。根据测量结果依据Cavendish分度将其分类，并根据三维重建成像选择不同的矫形手术术式。[结果]本组22例病人，随访2—4年，外观及功能均有不同程度的改善，未出现神经、血管和椎体等的损伤。[结论]根据螺旋CT扫描和三维重建检查结果，术前即可直观的明确先天性高肩胛症的病变程度，相互关系，伴发畸形，患侧肩胛骨与正常对侧肩胛骨的外观差异等，便于手术操作方案的制定，避免了手术操作的盲目性，减少医源性并发症的发生。

[ Objective] To investigate the effect of three-dimensional computered tomographic （3DCT） reconstruction on the classification of operation for congenital elevation of the scapula and choice of congenital elevation of the scapula. [ Method] Twenty-two patients with congenital elevation of the scapula were scanned with serial spiral CT and the images were three-dimensionally reconstraucted before operation. The scapular altitude difference of beth sides were measured with the reference of scapular spine. Different appropriate operations which based on these results and Cavendish＇s classification were chosen for different patients. [Result] Twenty-two patients were followed-up for 2 years to 4 years, the appearance and the range of motion were improved without injui＇ies of nerve, vessel and spine. [ Conclusion ] The pathological changes of congenital elevation of the scapula could be displayed clearly by 3DCT, so it is beneficial to choose the methods of operation and avoiding complications.