CT模拟两种穿刺入路行经皮骶椎成形术相关参数分析

The measurement of parameters related to percutaneous sacroplasty via two different approaches on CT imitation images

目的 CT模拟外侧入路及椎弓根间入路行经皮骶椎成形术，测量和分析主要相关参数。方法 随机选取200例患者行骨盆多层螺旋CT 扫描， ① 后处理工作站上模拟外侧入路经皮骶椎成形术，共600 节椎体，测量项目为S1 ～ S3骶椎左右进针距离、两侧旁开中心距离、椎弓根左右径、椎体高度等数据；② 后处理工作站上模拟椎弓根间入路经皮骶椎成形术，测量项目为穿刺点至骶椎S1上缘延长线与后背皮肤正中线焦点距离、进针深度及角度，并用SPSS19.0统计软件包进行统计分析。结果 ① S1 ～ S3骶椎左右进针距离（114.14 ± 14.26）mm、两侧旁开中心距离（102.92 ± 13.28）mm、椎弓根左右径（14.48 ± 1.79）mm、椎体高度（25.38 ± 2.37）mm；② 穿刺点至骶椎S1上缘延长线与后背皮肤正中线焦点距离（116.25 ± 13.98）mm、进针深度（106.86 ± 15.32）mm、进针角度（44.38 ± 5.90）°。结论 CT 模拟外侧入路及椎弓根间入路行经皮骶椎成形术相关测量参数为经皮骶椎成形术中穿刺针的选择及穿刺路径的规划提供基础影像解剖学数据。

Objective With the help of CT imitation images to measure important parameters that are related to percutaneous sacroplasty via lateral approach and via interpedicular approach. Methods A total of 200 patients＇ spiral CT images of sacrum were randomly selected. （1） On the post processing workstation the needle puncturing depth, the distance between the puncturing site and midline, the transverse distance of the pedicles and the height of vertebral body were measured in 600 vertebrae. （2） The skin incision site in the midline, the needle puncturing depth, the angle between the needle path and skin were imitated and measured on post processing workstation. The statistic analysis was performed using SPSS19.0 software. Results （1） The needle puncturing depth was （114.14 ± 14.26） ram. The distance between the puncturing site and midline was （102.92 ± 13.28） mm, and the transverse distance of the pedicles was （14.48 ± 1.79） mm. The height of vertebral body was （25.38 ± 2.37） mm. （2） The skin incision site in the midline was （116.25 ± 13.98） mm, the needle puncturing depth was （106.86 ± 15.32） mm, and the angle between needle path and skin was （44.38 ± 5.90） degree. Conclusion The measured results obtained from CT imitation images can provide the operator with important parameters that may ensure a successful percutaneous sac roplasty.