多层螺旋CT扫描及三维重建技术在小耳畸形再造患者肋软骨组织量评估中的应用

The application of multi-slice CT scanning and three-dimensional reconstruction technique in the evaluation of the costal cartilage tissue volume in patients with microtia deformity reconstruction

目的观察多层螺旋CT扫描及三维重建技术对小耳畸形再造患者肋软骨形态学参数测量结果的精确性,探讨该方法对小耳畸形再造术前肋软骨组织量评估及耳廓支架方案设计的参考价值。方法根据患者的体重、年龄等情况,设置64排螺旋CT设备扫描参数,对2018年5月至2020年3月在南阳市某三甲医院接受小耳畸形耳廓再造治疗的82例患者双侧1~12肋骨进行CT扫描,并运用三维重建技术模拟还原肋骨三维形态,测量三维图像中肋软骨近肋骨处宽度(W)及肋软骨全长(L),指导术前耳廓支架方案设计,并与术中肋软骨近肋骨处宽度(W#)及肋软骨全长(L#)实际测量值进行比较,以评价三维技术测量精确性。结果分别在三维图像和术中对207根手术相关肋软骨进行测量,结果显示,W为(9.71±1.59)mm,W#为(9.73±1.61)mm,差异无统计学意义(t=0.973,P=0.117);L为(82.96±21.38)mm,L#为(83.58±23.07)mm,差异无统计学意义(t=0.836,P=0.162)。所有术前参考三维重建技术对肋软骨评估结果所设计的耳廓支架制作方案均满足手术要求,参考价值较高。结论通过合理参数设置和三维重建技术处理,术前对小耳畸形再造患者肋软骨近肋骨处宽度及肋软骨全长评估精确,可为术前耳廓支架方案设计提供精确参考。

Objective Observe the accuracy of the measurement results of multi-slice spiral CT scan and three-dimensional reconstruction technique for costal cartilage morphology in patients with microtia deformity reconstruction,and discuss the reference value of this method for the evaluation of costal cartilage tissue volume and the design of auricle stent before microtia reconstruction.Methods According to the patient's weight,age,etc.,the scanning parameters of the 64-row spiral CT device were set.From May 2018 to March 2020,82 patients who underwent microtia deformity auricle reconstruction at a top three hospital in Nanyang City were bilaterally 1~12.CT scan of the ribs,and use the 3D reconstruction technology to simulate and restore the three-dimensional shape of the ribs,measure the width(W)of the costal cartilage near the rib in the 3D image(W)and the total length of the costal cartilage(L),guide the preoperative auricle stent design,and cooperate with the operation The actual measured values of the width of the middle rib cartilage near the rib(W#)and the total length of the costal cartilage(L#)were compared to evaluate the accuracy of the three-dimensional measurement.Results The 207 surgically-related costal cartilage were measured in three-dimensional images and intraoperatively.The results showed that W was(9.71±1.59)mm and W#was(9.73±1.61)mm,and the difference was not statistically significant(t=0.973,P=0.117);L is(82.96±21.38)mm,L#is(83.58±23.07)mm,the difference is not statistically significant(t=0.836,P=0.162).All the auricle stents designed with reference to the three-dimensional reconstruction technique for the evaluation results of costal cartilage meet the surgical requirements and have high reference value.Conclusion Through reasonable parameter setting and three-dimensional reconstruction technology,the width of the costal cartilage near the ribs and the total length of the costal cartilage are accurately evaluated before surgery,which can provide an accurate reference for the preoperative auricle stent design..