3D机器人系统锥形束计算机断层成像在颈椎成像中的应用价值

Application value of 3D robot system cone beam computed tomography in cervical spine imaging

目的:通过与常规X线摄影和CT进行比较,探讨Siemens双悬吊3D机器人系统(Multitom RAX)锥形束计算机断层成像(CBCT)在颈椎检查中的临床应用价值。方法:回顾性将在本院骨科就诊且因疑似颈椎疾病而分别行正侧位X线摄影(A组)、颈椎CT(B组)或3D RAX CBCT(C组)检查的60例患者纳入本研究。基于3组图像,测量每例患者颈椎解剖学参数,包括枕颈角(OC_(2)A)、第1胸椎倾斜角(T_(1)SA)、C_(2)与C_(7)矢状面轴向距离(cSVA)及颈椎前凸角(CL),并采用4级评分法评估图像质量。计算各组的辐射剂量,包括容积剂量指数(CTDI)、剂量长度乘积(DLP)和剂量面积乘积(DAP)。对3组的各项解剖学参数的测量结果、图像质量及辐射剂量指标进行比较。结果:A、C两组的OC_(2)A、CL及cSVA分别为18.29°±6.73°、10.52°±12.53°、(26.77±10.33)mm及18.14°±7.23°、10.54°±11.08°、(27.07±9.26)mm,两组间差异均无统计学意义(P>0.05);B组的OC_(2)A、CL及cSVA分别为14.78°±6.98°、3.32°±13.70°和(21.92±8.85)mm,与A、C两组间的差异均有统计学意义(P<0.05)。三组之间图像质量主观评分(A组:2.5±0.65、B组:3.72±0.45、C组:3.52±0.62)的差异有统计学意义(P<0.05)。C组的剂量长度乘积(DLP)较B组降低了54.6%,较A组DAP增大了86.9%,差异均有统计学意义(P<0.001)。结论:颈椎检查时,采用3D机器人系统CBCT较常规X线能提供质量更高的图像且相比CT有更精准的站立位测量数据及更低的辐射剂量,能为临床提供更精准、更有价值的测量参数。

Objective:By comparing with conventional radiography and CT,to investigate the clinical application and value of cone beam computed tomography(CBCT)scan by a Siemens double suspended 3D robot system(Multitom RAX)in cervical spine.Methods:60 patients with suspected cervical spine disease in the orthopedic department of our hospital were collected.The cervical spine of all patients was examined with frontal and lateral radiography(group A),CT(group B)and CBCT by a RAX 3D shoot(group C).The cervical anatomic parameters were measured,including pillow cervical angle(OC_(2)A),T_(1)-slope angle(T_(1)SA),sagittal axial distance of C_(2) to C_(7)(cSVA)and cervical vertebrae angle(CL).Image quality of the three groups were evaluated on a scale of 1 to 4.The radiation dose indexes in the three groups were calculated,including volume CT dose index(CTDIvol),dose length product(DLP)and(dose area product,DAP).The cervical anatomic parameters,image quality score and radiation dose indexes of the three groups were compared statistically.Results:The OC_(2)A,CL and cSVA of groups A and C were 18.29°±6.73°,18.14°±7.23°,10.52°±12.53°,10.54°±11.08°,(26.77±10.33)and(27.07±9.26)mm,respectively,and there was no significant difference between the two groups(all P>0.05).The OC_(2)A,CL and cSVA of group B were 14.78°±6.98°,3.32°±13.70°and(21.92±8.85)mm respectively,which were statistically different from those of group A and C(all P<0.05).There were statistically significant difference in the subjective scores of image quality among the three groups(Group A:2.5±0.65,Group B:3.72±0.45,Group C:3.52±0.62;P<0.05).The DLP of group C decreased by 54.6%compared with group B,and the DAP of group C increased by 86.9%compared with group A,the difference was statistically significant(both P<0.001).Conclusion:In cervical spine examination,the 3D robotic system CBCT can provide higher quality images than conventional X-rays,and has more accurate standing measurement data and lower radiation dose than CT,which can provide more accurate and valuable measurement parameters for clinical practice.