摘要
目的:分析CT对胸椎椎弓根螺钉置入螺钉位置及椎弓根内壁破坏程度的判断能力。方法:采用徒手法在5具尸体胸椎置入椎弓根螺钉,并进行CT扫描。然后根据螺钉CT影像分别由3位医师对螺钉的位置进行判断并与直视下观察结果进行比较。结果:CT对于Ⅰ度椎弓根螺钉的敏感度为33%,特异度为87%,阳性预测值为32%,阴性预测值为88%。CT对于Ⅱ度椎弓根螺钉的敏感度为100%,特异度为88%,阳性预测值为60%,阴性预测值为100%。Kapper值为0.603。结论:CT对椎弓根螺钉导致的椎弓根内壁破坏的评价结果较为可靠,对徒手法置入的胸椎椎弓根螺钉是否侵及内壁及侵及程度的判断准确性有限。
Abstract
Objective: To get the information of the ability of CT scanning as a tool to assess the accuracy of thoracic pedicle screw placement. Methods: Pedicle screws were inserted in five cadaveric spines. Speciments were scanned by CT and three observer graded the appearance of the screw based on CT scans. The results were compared with those of direct visualization group. Results: The authors arrived at a Kapper value of 0.603. For pedicle screw of grade Ⅰ, CT had a positive predictive value of 32%, a negative predictive value of 88%, a sensitivity of 33% and a specificity of 87%. Whereas, for pedicle screw of grade Ⅱ, CT had a positive predictive value of 60%, a negative predictive value of 100%, a sensitivity of 100% and a specificity of 88%. Conclusion: The authors conclude that CT scanning is a valid tool to assess the accuracy of thoracic pedicle screw placement, but in evaluating whether the screw has invaded the inner wall of the pedicle and its degree of invasion there has still some limitations.
关键词
胸椎 /
体层摄影术 /
X线计算机
Key words
thoracic vertebrae /
tomography /
X-ray computed
宋之明;刘 一;姚 迪;王淑清;陈 亮.
CT扫描和直视观察对比研究胸椎椎弓根螺钉的置钉位置[J]. 中国临床医学影像杂志. 2006, 17(3): 143-145
SONG Zhi-ming;LIU Yi;YAO Di;WANG Shu-qing;CHEN Liang.
Comparison of CT and direct visualization in thoracic pedicle screw placement[J]. Journal of China Clinic Medical Imaging. 2006, 17(3): 143-145
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