强直性脊柱炎骶髂关节超声与CT、MRI图像融合的方法及可行性研究

Methodology and feasibility study of US-CT/US-MRI image fusion in sacroiliac joints of ankylosing spondylitis patients

目的探讨强直性脊柱炎(AS)患者骶髂关节超声与CT、MRI图像融合的方法及其可行性。方法对84例AS患者(病例组)和30例正常成人(对照组)的骶髂关节进行超声与CT、MRI图像融合。图像融合操作分别在骶髂关节第1~3骶后孔横截面(level)进行,统计并比较超声与CT、超声与MRI两种融合形式在两组3个level的融合成功率。分析骶髂关节不同层面、背侧骶部皮脂厚度及AS患者骶髂关节的病变程度(Class1、Class2、Class3、Class4)与融合成功率的关系。结果病例组和对照组超声与CT图像在各level层面的融合成功率均>85%,组间比较差异均无统计学意义,病例组和对照组超声与MRIT1WI、T2WI图像在各level层面的融合成功率均<60%,组间比较差异均无统计学意义。超声与CT图像在病例组各level层面中Class1~4间的融合成功率比较,差异均无统计学意义;两组各level层面融合成功者与融合失败者间背侧骶部皮脂厚度比较,差异均有统计学意义(均P<0.05)。结论AS患者骶髂关节超声与CT图像融合成像的方法佳,具可行性,为融合图像联合技术的开展提供了技术基础。患者背侧骶部皮脂厚度是影响图像融合成功率的主要因素。

Objective To explore the methodology and feasibility of ultrasound(US)-CT/US-MRI fusion imaging in the sacroiliac joints(SIJ) of ankylosing spondylitis(AS) patients. Methods US - CT and US-MRI fusion imaging were performed on 84 SIJs patients(case group)and 30 normal adults(control group). The image fusion operation was performed at the level of the posterior hole of the ankle joint at level 1~3,respectively. The fusion success rates of US-CT/US-MRI fusion at the three levels of the two groups was compared. The relationship between the thickness of the sacroiliac joint,the thickness of the dorsal metatarsal area and the degree of lesions of the sacroiliac joint of AS patients(Class 1,Class 2,Class 3,Class 4)and the success rate of fusion were analyzed.Results In the case group and the control group,the fusion success rate of US-CT at each level were both >85%,and no significant differences were observed between the groups. Success rate of image fusion of US-MRI T1WI and US-MRI T2WI at each level were <60% in the case group and the control group,and no significant differences were observed between the two groups.The differences in the imaging success rate between the 4 classes of SIJ lesions were not significant at any level.There were significant differences in the thickness of the dorsal temporal sebum between the two groups of level-level fusion differences successors and fusion failures(all P<0.05). Conclusion Fusion imaging of US-CT of the SIJ suggested that US-CT fusion imaging is good and feasible,which provides a technical basis for the development of fusion image joint technology.The thickness of the patients’dorsal sebum is identified as the main factor affecting the success rate image fusion.