| 能谱CT脊髓前动脉造影在颈髓损伤患者中应用价值的初步探讨 |
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投稿时间：2018-03-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 朱旻宇 |
ZHU Min-yu |
南京医科大学附属上海一院临床医学院, 上海 200000
温州医科大学附属第一医院脊柱外科, 浙江 温州 325000 |
Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China |
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| 田纪伟 |
TIAN Ji-wei |
南京医科大学附属上海一院临床医学院, 上海 200000 |
Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China |
tjw609@163.com |
| 滕红林 |
TENG Hong-lin |
温州医科大学附属第一医院脊柱外科, 浙江 温州 325000 |
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| 吴诗阳 |
WU Shi-yang |
温州医科大学附属第一医院脊柱外科, 浙江 温州 325000 |
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| 王宇 |
WANG Yu |
温州医科大学附属第一医院脊柱外科, 浙江 温州 325000 |
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| 王靖 |
WANG Jing |
温州医科大学附属第一医院脊柱外科, 浙江 温州 325000 |
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| 王镇章 |
WANG Zhen-zhang |
温州医科大学附属第一医院放射影像科, 浙江 温州 325000 |
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| 期刊信息：《中国骨伤》2018年，第31卷，第5期，第425-430页 |
| DOI：10.3969/j.issn.1003-0034.2018.05.006 |
| 基金项目:温州市科技局公益性科技计划项目（编号：Y20170082） |
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中文摘要:
目的：探讨能谱CT脊髓前动脉造影在颈髓损伤患者中的应用价值，评价脊髓前动脉血流量改变与术后神经功能恢复的相关性。
方法：2014年1月至2016年6月对30例颈髓损伤患者行颈后路单开门椎管成形术治疗，其中男21例，女9例；年龄33～59（46.4±9.7）岁；均在伤后2周内接受颈后路单开门椎管成形术，其中开门减压3节段8例，4节段18例，5节段4例。术前3 d内及术后5 d进行能谱CT检查，重建脊髓前动脉并评估其术后血流量改善情况；术前1 d，术后5 d及1、6、12个月对患者进行颈椎JOA评分，并计算相应随访点术后JOA评分改善率。
结果：所有患者获得随访，时间12～30（17.4±7.6）个月。术前术后脊髓前动脉碘含量比值（ASA／VA）分别为0.75±0.20、0.89±0.02，术后较术前有显著改善（P<0.01），术后平均ASA／VA改善率为（21.05±12.45）%，且血流改善程度与术后1、6、12个月JOA评分改善程度之间存在线性正相关。
结论：能谱CT脊髓前动脉造影安全可行，成像满意，可定量评价脊髓前动脉血流量的改善程度；脊髓前动脉血流改善程度与神经功能恢复程度之间存在线性正相关，术后早期的脊髓前动脉血流改善程度或可作为预判患者神经功能恢复的参考指标之一。 |
| 【关键词】能谱CT 脊髓前动脉 血管造影术 脊髓损伤 |
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| Application of Gemstone Spectrum Imaging for anterior spinal artery in patients with cervical spinal injury |
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ABSTRACT
Objective: To discuss the value of Gemstone Spectrum Imaging (GSI) CT anterior spinal artery angiography in the patients with cervical spinal cord injury, and to evaluate the correlation between the change of the blood flow of the anterior spinal artery and the postoperative recovery of nerve function.
Methods: From January 2014 to June 2016, thirty patients who underwent cervical open door laminoplasty for spinal cord injury were retrospective analyzed and included 21 males and 9 females with an average age of (46.4±9.7) years old ranging from 33 to 59 years. Within 2 weeks after injury, open door laminoplasty was performed through cervical posterior approach. Among them, there were 8 cases of 3 segments of open door decompression, 18 cases of 4 segments, 4 cases of 5 segments. GSI CT were performed at 3 days before operation and 5 days after operation. The anterior spinal artery was reconstructed and evaluated the improvement of blood flow after operation. The cervical JOA score was calculated at 1 day before operation, 5 days after operation and 1, 6 and 12 months after operation, and the JOA score improvement rate of the corresponding follow-up points was calculated.
Results: All patients were followed up for 12 to 30 months with an average of (17.4±7.6) months. The iodine content ratio (ASA/VA) of the anterior spinal artery before and after operation was 0.75±0.20 and 0.89±0.02 respectively, the postoperative improvement was significantly higher than that before operation (P<0.01). The average ASA/VA improvement rate was (21.05±12.45)% after operation. There was a positive linear correlation between the improvement of blood flow and the improvement of JOA score at 1, 6 and 12 months after operation.
Conclusion: GSI CT anterior spinal artery angiography is safe and feasible, the imaging is satisfactory, it can quantitatively evaluated the blood flow of the anterior spinal artery. There was a positive linear correlation between the improvement of blood flow in anterior spinal artery and the recovery of neurological function. Early postoperative improvement of blood flow in the anterior spinal artery can be used as a reference index for predicting the recovery of neurological function in patients. |
| KEY WORDS Spectral CT Anterior spinal artery Angiography Spinal cord injury |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱旻宇,田纪伟,滕红林,吴诗阳,王宇,王靖,王镇章.能谱CT脊髓前动脉造影在颈髓损伤患者中应用价值的初步探讨[J].中国骨伤,2018,31(5):425~430 |
| 英文格式: | ZHU Min-yu,TIAN Ji-wei,TENG Hong-lin,WU Shi-yang,WANG Yu,WANG Jing,WANG Zhen-zhang.Application of Gemstone Spectrum Imaging for anterior spinal artery in patients with cervical spinal injury[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(5):425~430 |
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