曲面重组技术在强直性脊柱炎骶髂关节病变中的应用价值

Application value of curved planar reconstruction in sacroiliac joint of ankylosing spondylitis

目的探讨多层螺旋CT(MSCT)曲面重组(CPR)技术在强直性脊柱炎(AS)骶髂关节病变中的应用价值。方法33例临床确诊为AS的患者,采用5mm层厚、5mm层间距行双侧骶髂关节MSCT容积扫描,获得的原始横断面图像,再采用2.5mm层厚、1.2mm层间距重叠重建轴面源像,并将源像传输至AW4.0工作站,用reformat软件进行多平面重组(MPR)获得骶骨矢状面图像,分别在骶骨上缘1/4、1/2、3/4处沿骶骨走行划曲线进行CPR成像获得双侧骶髂关节冠状面图像。结果33例AS患者骶髂关节CPR图像,有较高的密度分辨率、空间分辨率,清楚、直观地在冠状面上显示了完整的骶髂关节及其病变,其中0级2例,Ⅰ级5例,Ⅱ级11例,Ⅲ级10例,Ⅳ级5例。结论骶髂关节CPR冠状面图像清晰,符合诊断要求,与横断面图像结合,更有助于全面观察AS骶髂关节病变的程度和范围。

Objective To determine the application value of curved planar reconstruction （CPR） of multislice spiral computed tomography（MSCT） in changes of sacroiliac joint of ankylosing spondylitis（AS）. Methods 33 patients with AS diagnosed clinically were chosen to take MSCT scanning of bilateral sacroiliac joints with the slice thick of 5mm and the slice interval of Smm. The primary images were transported to General Electric AW4.0 workstation, and the multiplanar reformatted sagittal images of sacrum were obtained by the reformat software, and further the coronary images of bilateral sacroiliac joints by CPR with the construction curves coincident with sacrums. Results All coronary images of bilateral sacroiliac joints by CPR were excellent in density and space resolution, and showed complete sacroiliac joints and their changes clearly and directly. Of all 33 cases, 2 were graded as grade 0, 5 grade Ⅰ , 11 grade Ⅱ, 10 grade Ⅲ, 5 grade Ⅳ, according to grading standard. Conclusion The coronary images of sacroiliac joint by CPR are enough clear and eligible for clinical diagnosis, and, in combination with transversal images, are helpful to complete assessment about the grade and scope of changes of sacroiliac joint in AS patients.