| Part? Comparative Study of The Monitoring Value of Energy Spectrum CT and Ultrasound in Bone TransportObjective:To compare the monitoring value of energy spectrum CT and ultrasound in bone transport process,and to explore the feasibility of the regeneration tissue formation in bone transport process monitored by energy spectrum CT.Methods :The 18 patients who underwent bone transport were examined by energy spectrum CT and ultrasonography at 2 weeks,4 weeks,6 weeks and 8 weeks after surgery,and the construction of the lateral callus,the formation of callus in the intramedullary cavity,the range of the organized hematoma and the nature of the vesicular area were observed,and the length of the bone transport area and the organized hematoma were measured.The radiation dose of energy spectrum CT scan was also calculated.Results:Primary callus structures were observed on CT and ultrasound at 2 to 8 weeks after surgery,and the callus and cortical bone could not be distinguished by ultrasound at 8weeks.At 2 to 8 weeks after surgery,the range of the organized hematoma and the quantity of callus in the intramedullary cavity were increasing that could be observed by CT and ultrasound increase with time rise.There was no statistically significant difference in the length of the systemic hematoma and the bone transport area measured by CT and ultrasound at 2 and 4 weeks after surgery(P>0.05),and there was statistically significant difference in the length of the systemic hematoma and the bone transport area measured by the two methods at 6 weeks after surgery(P<0.01).The length of the hematoma and bone transport was not measured by ultrasound at 8 weeks after surgery.The fluid vesicles detection rates of ultrasonography and CT were respectively16.67%(3/18)and 5.56%(1/18),with no statistically significant difference(P>0.05),but CT energy spectrum curve could identify the nature of fluid vesicles.The effective radiation dose of energy spectrum CT was(0.71+0.71)m Sv.Conclusion:Energy spectrum CT and ultrasound have advantages in monitoring the formation of regenerated tissue during bone transport.Energy spectrum technology can be used as a new monitoring method,and their complementary functions can guide clinical treatment earlier.Part? The Value Analysis of CT Energy Spectrum Technology in Assisting the Removal of External FixatorObjective:To investigate the correlation between HAP content rate and callus subsidence rate in bone transport area.The feasibility of removing the external fixator with the content of HAP in the material separation technology of energy spectrum CT was discussed.Methods :The 18 patients who underwent bone transport were examined by energy spectrum CT.And then to measure the HAP content in the bone transport area and calculate its percentage in the normal side.Follow-up was conducted to collect X-ray films in the positive and lateral position of tibiofibular bone after the removal of external fixator.No change was observed in the callus subsidence length of two consecutive times,and the callus subsidence rate was calculated(Callus subsidence length/the length of bone transport area).Finally the correlation between HAP content and callus subsidence rate in bone transport area was analyzed,and the diagnostic threshold,sensitivity,specificity and Youden index J of HAP content in callus subsidence rate < 10% were analyzed.Results:HAP content rate,in the bone transport area,was moderately correlated with callus subsidence rate(r=0.647 P< 0.05).With the callus subsidence rate < 10% as the reference,the area under the ROC curve of HAP content ratio was 0.888,the diagnostic critical value was 80.45%,the sensitivity and specificity were 80.00% and 87.50% respectively,and the Youden index J was 0.675.Conclusion:HAP content rate,in the bone transport area,was correlated with the callus subsidence rate.And HAP content rate can provide a new evaluation method for the timing of the removal of external fixator in patients with bone transport. |
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