Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.
Department of Orthopedics and Spine Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.
J Clin Neurosci. 2021 Jun;88:178-184. doi: 10.1016/j.jocn.2021.03.043. Epub 2021 Apr 14.
This study investigated whether the rib cage parameters estimated based on reconstructed three-dimensional (3D) images with biplanar stereoradiography reflect pulmonary functional states in adolescent idiopathic scoliosis (AIS) patients. A total of 67 Lenke type 1 or 2 AIS patients (59 females and 8 males, mean age 14.4 years) were enrolled. All patients underwent preoperative pulmonary functional tests (PFT) and biplanar stereoradiography. Vital capacity (VC) and forced vital capacity (FVC) pulmonary functional data were collected. Rib-cage parameters (maximum thickness, maximum width, thoracic index (TI), rib hump (RH), rib-cage volume (RCV), spinal penetration index (SPI), endothoracic hump ratio (EHR), vertebra-sternum angle (VSA), rib vertebral angle difference (RVAD), and vertebral lateral decentering (VLD)) were quantified from 3D images. Patients were divided into two groups: restrictive lung disorder (RLD) (%FVC < 80%) and non-RLD (%FVC ≥ 80%). The maximum width and RCV were significantly correlated with VC (p < 0.0001), and FVC (p < 0.0001). RH, EHR, and VSA were negatively correlated with %FVC (p < 0.01). TI, SPI, and RVAD were not correlated with any pulmonary parameters. The maximum widths of RLD patients were significantly shorter than those of the non-RLD patients (218.3 mm vs. 229.7 mm, p < 0.01). The RCV of RLD patients was significantly smaller than that of the non-RLD patients (3.94 L vs. 4.49 L, p < 0.0001). The maximum width and RCV measured by 3D images with biplanar stereoradiography reflected pulmonary functional variables in patients with AIS.
本研究旨在探讨基于双平面立体射线照相术重建的三维 (3D) 图像估计的胸廓参数是否反映青少年特发性脊柱侧凸 (AIS) 患者的肺功能状态。共纳入 67 例 Lenke 1 型或 2 型 AIS 患者(女性 59 例,男性 8 例,平均年龄 14.4 岁)。所有患者均接受术前肺功能检查 (PFT) 和双平面立体射线照相术。收集肺活量 (VC) 和用力肺活量 (FVC) 肺功能数据。从 3D 图像中量化胸廓参数(最大厚度、最大宽度、胸廓指数 (TI)、肋骨隆凸 (RH)、胸廓容积 (RCV)、脊柱穿透指数 (SPI)、胸内隆凸比 (EHR)、椎体胸骨角 (VSA)、肋骨椎体角度差 (RVAD) 和椎体侧偏距 (VLD))。将患者分为两组:限制性肺障碍 (RLD) (%FVC < 80%) 和非 RLD (%FVC ≥ 80%)。最大宽度和 RCV 与 VC(p < 0.0001)和 FVC(p < 0.0001)显著相关。RH、EHR 和 VSA 与 %FVC 呈负相关(p < 0.01)。TI、SPI 和 RVAD 与任何肺参数均无相关性。RLD 患者的最大宽度明显短于非 RLD 患者(218.3 毫米比 229.7 毫米,p < 0.01)。RLD 患者的 RCV 明显小于非 RLD 患者(3.94 升比 4.49 升,p < 0.0001)。双平面立体射线照相术重建 3D 图像测量的最大宽度和 RCV 反映了 AIS 患者的肺功能变量。