青少年侧凸椎体形态的三维CT分析及其严重程度的相关性

IF 2.5 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES

Journal of Radiation Research and Applied Sciences Pub Date : 2025-09-13 DOI:10.1016/j.jrras.2025.101948

Lei Qian , Yingzi Jiang , Ting Zhang , Ke Sun , Xinxuan Xu , Jun Yu

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引用次数: 0

摘要

目的分析青少年特发性脊柱侧凸（AIS）脊柱CT三维重建的椎体形态参数特征，并探讨其与脊柱侧凸严重程度的相关性。方法采用回顾性病例对照研究，纳入305例年龄10 ~ 18岁的AIS患者。患者分为重度组（Cobb角≥45°）和非重度组。采用CT三维重建测量椎体形态学参数，包括骨结构（椎体前后缘、椎板、棘突）与非骨结构（椎间盘前后缘、层间间隙、棘突间隙）的比例。测量以下比率：前后比（A-P%，前后长度之比），前椎板比（A-L%，前长度与椎板长度之比），前棘突比（A-S%，前长度与棘突长度之比）。此外，还测量了椎体和椎间盘的高宽深比（Rhw, Rhd, Rwd）、椎体旋转（VR）、肋骨驼峰指数（RH）和胸骨移位（SS）。进行单因素和多因素logistic回归分析。结果严重组胸椎A-P%、A-L%、A-S%、椎间盘高度/重量（Rhw）、椎间盘高度/深度（Rhd）升高，胸椎Rhw降低（P < 0.05）。重度组肋骨驼峰（RH）和胸骨移位（SS）增高（P < 0.05）。单因素和多因素回归分析显示，胸椎近端Cobb角、胸椎A-P%、骨性A-P%、非骨性A-P%、A-L%、Disc Rhw、Disc Rhd、RH和SS与脊柱侧凸严重程度呈正相关，而身高、体重、椎体Rhw、腰椎非骨性A-S%与脊柱侧凸严重程度呈负相关。结论胸椎椎间盘形态参数及三维畸形指标与AIS严重程度密切相关，为临床评价和治疗提供了新的参考依据。

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3D CT analysis of vertebral morphology in adolescent scoliosis and its severity correlation

Purpose

To analyze the characteristics of vertebral morphological parameters from spinal CT 3D reconstruction in adolescents with idiopathic scoliosis (AIS) and explore their correlation with scoliosis severity.

Methods

A retrospective case-control study enrolled 305 AIS patients aged 10–18 years. Patients were divided into severe (Cobb angle ≥45°) and non-severe groups. CT three-dimensional reconstruction was used to measure vertebral morphological parameters, including ratios of bony structures (anterior and posterior margins of the vertebral body, lamina, spinous process) and non-bony structures (anterior and posterior margins of the intervertebral disc, interlayer space, interspinous space). The following ratios were measured: anterior-posterior ratio (A-P%, the ratio of anterior to posterior length), anterior lamina ratio (A-L%, the ratio of anterior length to lamina length), anterior spinous process ratio (A-S%, the ratio of anterior length to spinous process length). Additionally, the height width/depth ratios of the vertebral body and intervertebral disc (Rhw, Rhd, Rwd), vertebral rotation (VR), rib hump index (RH), and sternal shift (SS) were also measured. Univariate and multivariate logistic regression analyses were performed.

Results

Thoracic A-P%, A-L%, A-S%, Disc height/wight (R_hw), Disc height/depth (R_hd) increased, while thoracic vertebral R_hw decreased in severe group (P < 0.05). Rib Hump (RH) and Sternal Shift (SS) were higher in severe group (P < 0.05). The univariate and multivariate regression analyses showed that proximal thoracic Cobb angle, thoracic A-P%, A-P% osseous, A-P% non-osseous, A-L%, Disc R_hw, Disc R_hd, RH and SS were positively associated with scoliosis severity, while height, weight, Vertebra R_hw, lumbar A-S% non-osseous were negatively associated with it.

Conclusion

Thoracic vertebral and disc morphological parameters, along with 3D deformity indices, are closely related to AIS severity, providing new references for clinical evaluation and treatment.

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来源期刊

Journal of Radiation Research and Applied Sciences MULTIDISCIPLINARY SCIENCES-

自引率

5.90%

发文量

130

审稿时长

16 weeks

期刊介绍： Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.