EVALUATION OF MULTI-SLICE SPIRAL CT SCAN AND IMAGE RECONSTRUCTION TECHNOLOGY IN ESTIMATING COSTAL CARTILAGE VOLUME_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGYongzhen ^1,2 ,  HELeren ^1,2 , LIULi ³ , CHENWeiwei ³ , JIANGHaiyue ^1,2 , SHANGQiaoli ^1,2

1. Peking Union Medical College, Beijing, 100144, P. R. China;
2. the 7 th Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100144, P. R. China;
3. Department of Radiology, Plastic Surgery Hospital of Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100144, P. R. China;

Corresponding?author：

HELeren, Email: heleren@sina.com

Keywords：

Multi-slice spiral CT; Image reconstruction; Costal cartilage; Microtia

DOI：

10.7507/1002-1892.20140274

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Objective To investigate the accuracy of multi-slice spiral CT (MSCT) scan and image reconstruction technology for measuring morphological parameters of costal cartilages and to evaluate the volume of costal cartilages. Methods Between March and August 2013, 75 patients with congenital microtia and scheduled for auricle reconstruction were included in the study. Of 75 patients, there were 49 males and 26 females with a mean age of 8 years and 5 months (range, 5 years and 7 months to 32 years and 7 months) and a mean weight of 29.5 kg (range, 21-82 kg). A Philips Brilliance 64 MSCT machine was used to scan 1st-12th costal cartilages with the parameters based on the age and weight of the patients. All the data were transported to the workstation for reconstructing the image of the costal cartilages with the technique of maximum intensity projection (MIP) and volume rendering technique (VRT). Then the morphologies of costal cartilages were observed through the images on VRT; the width of the costal cartilaginous ends close to ribs (W) and the length of the total cartilage (L) were measured and compared with their counterparts (W' and L') after the costal cartilages were harvested during the processes of auricle reconstructions to analyze consistency between these two sets of data. Results The morphologies of ribs and costal cartilages shown on VRT image got fine sharpness, verisimilitude, and stereoscopic impressions. A total of 192 costal cartilages were examined. The results showed that the widths of the costal cartilaginous ends close to ribs (W) was (9.69±1.67) mm, and W' was (9.73±1.64) mm, showing no significant difference between W and W' (t=-1.800, P=0.073), and interclass correlation coefficient (ICC) test showed Cronbach's α=0.993. The length of the total cartilage (L) was (83.03±23.86) mm, and L' was (81.83±16.43) mm, showing no significant difference between L and L' (t=1.367, P=0.173), and ICC test showed Cronbach's α=0.904. Linear-regression analysis showed L=1.28×L'-21.93 (R²=0.780, F=673.427, P=0.000). The results suggested there was a good consistency between these two sets of data. Conclusion Scanning costal cartilages with appropriate parameters and reconstructing the cartilaginous image with MIP is an effective method to measure the width and length of costal cartilage and to estimate costal cartilage volume, which can provide accurate reference for plastic surgery together with reading the morphology from the image on VRT.

Citation： WANGYongzhen, HELeren, LIULi, CHENWeiwei, JIANGHaiyue, SHANGQiaoli. EVALUATION OF MULTI-SLICE SPIRAL CT SCAN AND IMAGE RECONSTRUCTION TECHNOLOGY IN ESTIMATING COSTAL CARTILAGE VOLUME. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1266-1269. doi: 10.7507/1002-1892.20140274 Copy

1.	Brent B.Microtia repair with rib cartilage grafts:a review of personal experience with 1000 cases.Clin Plast Surg, 2002, 29(2):257-271.
2.	莊洪興, 蔣海越, 潘博, 等.先天性小耳畸形的皮膚軟組織擴張器法外耳再造術.中華整形外科雜志, 2006, 22(4):286-289.
3.	周佳宇, 林琳, 蔣海越, 等.個性化肋軟骨采集及耳支架雕刻.中華耳科學雜志, 2013, 11(4):502-505.
4.	Cervelli V, Bottini DJ, Gentile P, et al.Reconstruction of the nasal dorsum with autologous rib cartilage.Ann Plast Surg, 2006, 56(3):256-262.
5.	von Gregory HF, Fischer H, Eppstein RJ, et al.Framework fabrication with rib cartilage in partial and total nasal reconstruction.Facial Plast Surg, 2014, 30(3):306-317.
6.	王永振, 何樂人, 林琳, 等.八大處法耳廓再造Ⅰ期術后擴張早期感染的處理.中華耳科學雜志, 2013, 11(4):499-501.
7.	Ontell FK, Moore EH, Shepard JA, et al.The costal cartilages in health and disease.Radiographics, 1997, 17(3):571-577.
8.	百曉珺, 胡兵, 楊松林.二維和三維超聲技術在耳郭支架材料選擇中的應用.中國美容整形外科雜志, 2011, 22(8):483-486.
9.	趙建, 韓奕, 朱瑾, 等.肋軟骨骨折:高頻超聲與MSCT對照觀察.中國醫學影像技術, 2012, 28(5):993-996.
10.	Subhas N, Kline MJ, Moskal MJ, et al.MRI evaluation of costal cartilage injuries.AJR Am J Roentgenol, 2008, 191(1):129-132.
11.	Lewis MA.Multislice CT:opportunities and challenges.Br J Radiol, 2001, 74(885):779-781.
12.	Malghem J, Vande Berg B, Lecouvet F, et al.Costal cartilage fractures as revealed on CT and sonography.AJR Am J Roentgenol, 2001, 176(2):429-432.
13.	陳志明, 劉鋒.16層螺旋CT多種重建方法在診斷肋軟骨骨折中的應用.中國CT和MRI雜志, 2013, 11(4):93-95.
14.	Kim H, Hwang JH, Lim SY, et al.Preoperative rib cartilage imaging in 3-dimensional chest computed tomography for auricular reconstruction for microtia.Ann Plast Surg, 2014, 72(4):428-434.
15.	Park CH, Kima TH, Haam SJ, et al.Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum.Interact Cardiovasc Thorac Surg, 2013, 17(5):757-763.
16.	Wallis JW, Miller TR, Lerner CA, et al.Three-dimensional display in nuclear medicine.IEEE Trans Med Imaging, 1989, 8(4):297-303.
17.	馬洪宇, 袁方, 張榮恒, 等.多層螺旋CT三維重建技術在肋軟骨骨折診斷中的價值.中國傷殘醫學, 2013, 21(11):282-283.

1. Brent B.Microtia repair with rib cartilage grafts:a review of personal experience with 1000 cases.Clin Plast Surg, 2002, 29(2):257-271.
2. 莊洪興, 蔣海越, 潘博, 等.先天性小耳畸形的皮膚軟組織擴張器法外耳再造術.中華整形外科雜志, 2006, 22(4):286-289.
3. 周佳宇, 林琳, 蔣海越, 等.個性化肋軟骨采集及耳支架雕刻.中華耳科學雜志, 2013, 11(4):502-505.
4. Cervelli V, Bottini DJ, Gentile P, et al.Reconstruction of the nasal dorsum with autologous rib cartilage.Ann Plast Surg, 2006, 56(3):256-262.
5. von Gregory HF, Fischer H, Eppstein RJ, et al.Framework fabrication with rib cartilage in partial and total nasal reconstruction.Facial Plast Surg, 2014, 30(3):306-317.
6. 王永振, 何樂人, 林琳, 等.八大處法耳廓再造Ⅰ期術后擴張早期感染的處理.中華耳科學雜志, 2013, 11(4):499-501.
7. Ontell FK, Moore EH, Shepard JA, et al.The costal cartilages in health and disease.Radiographics, 1997, 17(3):571-577.
8. 百曉珺, 胡兵, 楊松林.二維和三維超聲技術在耳郭支架材料選擇中的應用.中國美容整形外科雜志, 2011, 22(8):483-486.
9. 趙建, 韓奕, 朱瑾, 等.肋軟骨骨折:高頻超聲與MSCT對照觀察.中國醫學影像技術, 2012, 28(5):993-996.
10. Subhas N, Kline MJ, Moskal MJ, et al.MRI evaluation of costal cartilage injuries.AJR Am J Roentgenol, 2008, 191(1):129-132.
11. Lewis MA.Multislice CT:opportunities and challenges.Br J Radiol, 2001, 74(885):779-781.
12. Malghem J, Vande Berg B, Lecouvet F, et al.Costal cartilage fractures as revealed on CT and sonography.AJR Am J Roentgenol, 2001, 176(2):429-432.
13. 陳志明, 劉鋒.16層螺旋CT多種重建方法在診斷肋軟骨骨折中的應用.中國CT和MRI雜志, 2013, 11(4):93-95.
14. Kim H, Hwang JH, Lim SY, et al.Preoperative rib cartilage imaging in 3-dimensional chest computed tomography for auricular reconstruction for microtia.Ann Plast Surg, 2014, 72(4):428-434.
15. Park CH, Kima TH, Haam SJ, et al.Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum.Interact Cardiovasc Thorac Surg, 2013, 17(5):757-763.
16. Wallis JW, Miller TR, Lerner CA, et al.Three-dimensional display in nuclear medicine.IEEE Trans Med Imaging, 1989, 8(4):297-303.
17. 馬洪宇, 袁方, 張榮恒, 等.多層螺旋CT三維重建技術在肋軟骨骨折診斷中的價值.中國傷殘醫學, 2013, 21(11):282-283.

Chinese Journal of Reparative and Reconstructive Surgery

EVALUATION OF MULTI-SLICE SPIRAL CT SCAN AND IMAGE RECONSTRUCTION TECHNOLOGY IN ESTIMATING COSTAL CARTILAGE VOLUME

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