基于超薄层切片与计算机辅助识别技术股骨头坏死病灶测量比对研究

A comparative study on the measurement of femoral head necrosis lesions using ultra thin layer slicing and computer aided identification

目的 :将计算机半自动股骨头坏死识别及定量检测软件系统与基于超薄层切片的测量方法进行比对分析,确认软件测量法的精确性和实用性。方法:回顾性分析2012年6月至2013年12月收治的24例单侧晚期(ARCO分期为Ⅲ、Ⅳ期)股骨头缺血性坏死患者术前双髋X线片与MRI资料,男15例,女9例,平均年龄(65.1±8.8)岁(33~74岁)。在影像学系统界面和计算机辅助技术(CAD)区域识别种子点自适应寻找方法软件系统下,计算出患侧MRI上股骨头坏死组织区域的体积,与患侧全髋人工关节置换术后的基于超薄层切片的测量方法进行比对分析。结果:软件测量24髋坏死病灶的体积为(20.00±3.04)cm^3(18.72~21.29 cm^3),大体病理超薄层切片测得24髋股骨头坏死病灶的体积为(19.89±3.17)cm^3(18.55~21.23 cm3)。计算机软件与病理超薄层切片两种测量下,股骨头坏死病灶体积值的差异无统计学意义(t=-1.227,P=0.232)。结论:计算机半自动股骨头坏死识别软件系统可以较精确地测算MRI图像上股骨头坏死病灶的区域,与病理量化的测算范围符合,可以指导临床治疗。

Objective：To compare the differences between computer aided identification and ultra thin layer slicing in measuring the lesions of femoral head necrosis,and to confirm the accuracy and practicability of computer aided method.Methods：From June 2012 to December 2013,the X ray and MRI of 24 patients（24 hips on unilateral） were reviewed,who had avascular necrosis of the femoral head（ANFA） at late stage（stage Ⅲ and Ⅳ） according to the ARCO international staging system. There were 15 males and 9 females,with an average age of（65.1±8.8） years old,ranged 33 to 74 years old. Based on the software system with seeds point identification,the ragional adaptive search method with computer aid was used to calculate the volume of necrotic lesion in femoral on MRI. Then the pathological slices of those intraoperative femoral heads were made to measure the gross volume of necrotic lesion in femoral head,and the values were compared with the data in the computer.Results：For 24 hips,by the calculation of computer,the necrotic volume was（20.00±3.04） cm3（ranged,18.72 to 21.29 cm3）.Under the pathological section,the necrotic volume of the femoral head was（19.89±3.17） cm3（ranged,18.55 to 21.23 cm3）. In computer and pathology two kinds of measurement,the two entire femoral head volume had no significant difference using these two measurements（t=-1.227,P=0.232）. Conclusion：Computer aided identification for necrotic area of femoral head adaptive can demonstrate the morphology of femoral head necrosis accurately and reliably,which will help surgeon better understand the morphology and orientation in femoral head.