寰枢关节区分解、融合、透亮及伪彩三维成像技术的应用

Application of separating fusing opacifying and false-coloring-volume rendering imaging technique in the region of atlantoaxial joint

目的 探讨寰枢关节区骨血管分解、融合、透亮及伪彩三维成像（SFOF-VR）的技术方法,评价其应用价值.方法 从头颈部三维CT血管成像检查者中选择35例,其中包括未见异常（6例）、变异及病变者（29例）的影像资料.利用其原始资料,首先进行常规VR成像,然后进行SFOF-VR成像.比较SFOF-VR、VR三维图像的特点,显示解剖结构及诊断其变异或病变情况,并进行x2精确概率法统计学分析.结果 35例研究对象包括6例未发现异常,16例寰椎或椎动脉变异,6例椎动脉病变,7例寰枢关节骨折或脱位,均获得满意的SFOF-VR图像.SFOF-VR图像实现单独或联合显示寰椎、枢椎、椎动脉等结构,并任意切割、伪彩及三维解剖测量,较VR图像清楚、直观,显示解剖、变异及病变全面、准确.35例SFOF-VR图像显示空间结构、遮挡结构、空间测量、变异和病变及图像边缘分级优、良、一般、差分别为25、7、3、0,31、3、1、0,26、3、6、0,23、7、5、0,0、10、20、5例 VR图像相应分别为2、5、24、4,0、2、8、25,0、7、25、3,5、6、23、1,29、4、2、0例,差异有统计学意义（χ2值依次分别为40.259、61.444、42.245、24.220、51.299,P值均〈0.01）.结论 SFOF-VR三维成像是一种新的图像处理技术,能很好显示寰枢关节区骨、血管结构并为影像诊断、外科手术提供解剖依据.

Objective To evaluate the techniques of separating, fusing, opacifying and falsecoloring- volume rendering（ SFOF-VR）3D imaging on the bone and blood vessels in the region of atlantoaxial joint（AAJ）. Methods SFOF-VR 3D imaging was performed on 35 cases, including normal （n = 6）,variations and lesions（ n =29）, which were selected from cases with the head-neck CTA examination. With the original scanning data, the VR imaging was performed, then SFOF-VR imaging. Comparisons were made between the features of 3D images of SFOF-VR and VR in showing the anatomy, diagnosing the variation and lesion of AAJ and VA, and the results were analyzed by using the Fisher exact test. Results The results of 35 cases included 6 normal cases in the region of atlantoaxial joint and VA, 16 variations in atlantoaxial joint or VA, 6 cases with arteriosclerosis in VA and 7 cases with fracture or dislocation of atlantoaxial joint. All SFOF-VR imaging are satisfactory. SFOF-VR imaging can show the atlas, epistropheus and VA independently or jointly, cut or color the structures freely and get 3D measurements in any direction.Comparisons showed that SFOF-VR images were much clearer and more comprehensive than VR in displaying the anatomy, variation and lesions of AAJ and VA. Statistical differences were found in showing the spatial structure, blocking structure, space measurement, variation and disease and image edge （ there are25,7,3,0, 31,3,1,0, 26,3,6,0, 23,7,5,0, 0,10,20,5 cases for SFOF-VR image with excellent,good, ordinary and poor quality, and 2,5,24,4, 0,2,8,25, 0,7,25,3, 5,6,23,1, 29,4,2,0 cases for VR χ2 values 40. 259, 61.444, 42.245, 24.220, 51.299, P〈0. 01 ）. Conclusions SFOF-VR is a new 3D imaging technique which can clearly and directly show the bones and blood vessels in the region of AAJ.It can provide anatomical information for imaging diagnosis and surgical operation.