论文摘要
第一部分 多层螺旋CT多平面重建在特发性脊柱侧凸形态学中的应用 背景： 脊柱侧凸（Scoliosis）是指前后位X光片上脊柱侧方弯曲超过10°的脊柱三维畸形。其中特发性脊柱侧凸（Idiopathic Scoliosis，IS）好发于青少年，是小儿脊柱常见的畸形之一。脊柱侧凸不仅表现为外观畸形，还会影响儿童心肺的发育和成熟，对儿童的身心都带来了极大的创伤，极大危害了青少年的正常成长，是一个亟待解决的问题。针对特发性脊柱侧凸的病因，国内外许多学者进行了大量的探索工作，但到目前为止，所有关于AIS病因的研究尚无定论。要准确找到脊柱侧凸的病因就必须对脊柱的形态有详细的了解。目前仅有为数不多的几个研究相对准确地评估了侧凸的脊柱，并且发现胸椎顶椎区域存在胸前凸或胸后凸减小，脊柱的前柱相对过度生长，引起了胸椎的前凸或后凸减小，导致侧凸的进展，但应用CT对特发性脊柱侧凸患者胸腰椎进行椎体和椎弓的准确测量迄今为止尚未见报道。 目的： 探讨在特发性脊柱侧凸中应用多层螺旋CT多平面重建技术，进行特发性脊柱侧凸女孩椎体形态测量，并与年龄和性别相配的对照组椎体形态测量结果相比较，确立特发性脊柱侧凸前后成分发育异常的形态学结论。 材料与方法： 52例10～18岁特发性脊柱侧凸青少年女孩和54例年龄性别相配的非AIS侧凸对照组女孩进行了多层螺旋CT胸腰椎扫描。采用3D-MPR技术分别测量了胸腰椎椎体的各项参数（包括前后柱），将患者和对照按年龄分为第Ⅰ组（10～14岁）和第Ⅱ组（15～18岁），分别对相应椎体的前缘高度、后缘高度、椎体中心宽度、中心前后径、椎弓根面积、椎弓根高度、椎弓根宽度和上下关节突长度进行了比较。 结果： 和对照组相比，10～14岁年龄组AIS组女性患者前柱椎体高度较高、后柱相对较小，椎体前后径相对较长，椎体存在楔形变，凸凹侧椎弓根不对称和凸凹侧上下关节突长度不对称。胸腰椎前后柱的比例明显不同于对照组，而15～18岁年龄组AIS组
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