儿童半椎体畸形主弯及节段弯在不同体位的影像分析

Imaging analysis on main curvature and segmental curvature in different positions for children with hemiverte bra deformity

[目的]探讨儿童先天性半椎体畸形脊柱侧弯主弯及节段弯在不同体位与影像检查方法之间的关系。[方法]回顾性分析2015年1月~2018年12月在本院就诊的半椎体畸形24例患儿的影像学资料,对其站立位全脊柱X线片、仰卧位CT和仰卧位MRI图像的节段弯、主弯、节段性后凸/前凸进行测量比较。[结果]X线片图像主弯比CT图像主弯大(5.96±4.98)°,X线片图像主弯比MRI图像主弯大(6.17±5.58)°;主弯X线片与CT、X线片与MRI的Cobb角差异具有统计学意义(P<0.05),主弯角度CT与MRI比较差异无统计学意义(P>0.05)。节段弯及节段后凸/前凸角度在三种成像方法间差异无统计学意义(P>0.05)。相关性方面,X线片与CT主弯测量值呈显著正相关(r=0.949,P<0.05),X线片与MRI的主弯测量值呈显著正相关(r=0.935,P<0.05)。[结论]节段弯不随体位的改变而变化,能真实反映畸形程度,可用于评估站立前期患儿半椎体畸形程度。此外,可以通过仰卧位CT或MRI的主弯估算其站立位全脊柱X线片主弯的角度。

[Objective]To investigate the relationships of main curvature and segmental curvature in congenital hemiverte bra deformity among different imaging examinations under different position in children.[Methods]A retrospective study was conducted on 24 children who had radiographic examinations for hemivertebra deformity in our hospital from January 2015 to December 2018.The main curvature and segmental curvature,kyphotic/lordotic angles measured by full-length spine X-ray film on standing,CT and MRI on supine position were compared and analyzed.[Results]The main curvature in the X-ray film was(5.96±4.98)°greater than that in CT image,whereas(6.17±5.58)°greater than that of MRI image,which were of statistical significance(P<0.05),although no a statistically significant difference in the main curvature was proved between CT and MRI measurements(P>0.05).However,there were no significant differences regarding to the segmental curvature,kyphotic/lordotic angles among the 3 imaging examinations(P<0.05).In term of relationships among the radiographic assessments,there were sig nificantly positive correlations in the main curvature between the X ray and CT(r=0.949,P<0.05),as well as between X ray and MRI(r=0.935,P<0.05).[Conclusion]As the segmental curvature does not change with the change of position,it might be used as parameter to truly reflect the degree of the deformity in children who cannot stand.The main curvature on the standing fulllength spine radiographs might be estimated by the main curvature measured on CT or MRI images on the supine position.