The Clinical Application Of Msct 3d Imaging To Adolescent Scoliosis

0bjeetive: The purpose of this study is to explore the clinical value of 3D multi-slice helicl computed tomograph(MSCT) to the scoliosis with the adolescent in the clinical application.Materials and Methods:Methods:53 adolescents of spinal deformity were studied from 2008 to 2009,of which 28 cases of adolescents with congestional scoliosis,25 cases with idiopathic scoliosis . All cases were classied into 2 group,A and B.All the patients of group A of congestional scoliosis were examined by plain radiography,MSCT and MR .Oberseving the fine and whole structure of spine and measure data which including:the sagittal and axial diameter,spatial relations deformity and the best fixed implanted vertebral body for implanting screws and rods system.X-ray data for same patients were measured.Statistical analysis is implied.Using for ststistical analysis package SPSS 13.0,p<0.05 shows stationtical significance.Using spearman correlation and t test analysis.Other 25 cases of idiopathic scoliosis of group B were done Lenke type,lumbar scoliosis type,thoracic scoliosis classification under the guidence of the experienced surgeon,evaluating combined of three-dimensional reconstruction image data and postoperative surgical data,and exploring it's clinical value which including orthopedic effect,location, fracture,with or without divation,loose,spatial relationships of implanted screws and rods system.Results:In the group A, 27 deformities found by X-ray in all,97 deformities were detected by MSCT.In which combined of calcification with liver in 2 cases,cpmpressed deformity kidney in 2 cases and dislocation in 6 cases,renal stone in 1 case,hydronephrosis in 3 cases,reduced left lung volume in 3 cases and right in 1case, heart is pressured in 4 cases.About the location of deformities,19 cases in thoracic vertebrae,3 cases in thoracic-lumbar vertebrae,6 cases in lumbar vertebrae,2 cases in cervical-thoracic-lumbar vertebrae,1 case in cervical-thoracic vertebrae,2 cases in cervical-thoracic fusion.Group A were examined by MR,TCS,chiari-1 malformation in 2 cases, diastematomyelia in 3 cases,syringomyelia,meningomyelcele,spinal cord edema in 1 case,the rest 18 cases were normal.In the group A,the central vertebral body of convex side of scoliosis 1 case in thoracic vertebrae4,5,12,lumbar vertebral2/3,2 cases in thoracic vertebrae5,7,8,11/12,lumbar vertebrae3,3 cases in thoracic vertebrae9,thoracic12/lumbar vertrbrae1,lumbar vertebrae2,5 cases in thoracic vertebrae10.The parameter about 672 vertebral arches of 28 cases were measured precisely by MPR before orthopedic operation.In idiopathic scoliosis of 15 cases,121 deformities of vertebral arches were found.In all cases, there were 64 deformities in abnormal,breadth of 75 vertebral arches less than 3.5mm.In congestional scoliosis of 13 cases,106 deformities of vertebral arches were found,in all cases ,there were 72 deformities in abnormal,breadth of 34 vertebral arches less than 3.5mm,3 vertebral arches had none of development.In the group B,25 cases were classified into 6 types according to the Lenke type.11 cases wer classified into Lenke1 type,5 cases into Lenke3,7 cases into Lenke5,2 cases into Lenke 6.In the advanced classification of lumbar,6 cases in A type,5 cases in B,14 cases in C.In the advanced clasification of thoracic,20 cases in normal, kyphosis angle increased in 2 cases, 3 cases of kyphosis angle decreased.In all cases ,master curve of scoliosis in right is 39 cases,which in left is 14 cases.Conclusion:3DMSCT combined with MPR/CPR,VR, SSD images can clearly better display the whole and detailed anatomy structure of scoliosis than traditional X-ray examination and obtain more useful information which can provide actual evidence for operating plan. The study also found that scoliosis to the right of adolescent is more common,espically in the idiopathic scoliosis.In the data of width of thoracic vertebral arches,thoracic vertebral arch4 is the narrowest,,and both sides have gradually widened to the trend.In arches of congestional and idiopathic scoliosis,the former is delicate arch deformity rare and distorted relatively mainly,the latter is delicate arch deformity mainly and distorted relatively rare. There is no significant correlation between the angle of major curve of scoliosis and convex,concave side of the arch width of vertebral center in main curve.