Evaluation Of Blood Supply Of Femoral Head After Femoral Neck Fracture In Middle-aged And Elderly Patients By CT Gemstone Spectral Perfusion Imaging

Objective:To evaluate the blood supply of femoral head in patients with femoral neck fracture(FNF)in middle-aged and elderly patients with gemstone spectral perfusion imaging.Methods:Totally 25 middle-aged and elderly patients with unilateral and traumatic femoral neck fracture were examined with 256 rows of single-source dual-energy CT(Revolution CT),gemstone spectral perfusion scan.Simultaneously,CT Perfusion imaging and gemstone spectrum imaging data were obtained.The images were reconstructed to slice thickness 5mm,spacing thickness 5mm.The image postprocessing using CT Bone Perfusion and Three Phase Liver software,Obtained the Perfusion pseudo color map,one side and healthy side of blood flow(BF),blood volume(BV),time to peak(TTP),mean transit time(MTT)and the content of iodine(water),the content of water(iodine).Using SPSS 22.0 software for statistical analysis,analysis the difference between one side and healthy side,using two-sample t-test,P<0.05 for the difference was statistically significant.Results:1.CT image:CT gemstone spectrum perfusion imaging can clearly display the patient's Computed tomography angiography(CTA)and volume rendring technique(VRT)images while obtaining the gemstone spectrum and perfusion parameters,and visually observe the patient's fracture type and the relationship between bone and adjacent artety.2.CT perfusion imaging:BF(17.63?7.51)ml/(100 g·min)on the affected side and BF(16.60?4.17)ml/(100 g·min)on the healthy side,there were no statistically significant difference between the two(P=0.451>0.05);BV(1.22?0.58)ml/100g on the affected side and BV(1.34?0.49)ml/100g on the healthy side,there were not statistically significant(P=0.579>0.05);TTP(31.65?4.48)s on the affected side,TTP(37.28?5.77)s on the healthy side,the affected side was significantly lower than the healthy side,the difference was statistically significant(P<0.05);the affected side of MTT(7.39?1.75)s,the healthy side of MMT(9.08?2.04)s,the affected side was significantly lower than the healthy side,and the difference was statistically significant(P<0.05).3.CT gemstone spectrum imaging:the iodine(water)content of the affected side is(55.80?6.88)100?g/cm~3,the iodine(water)content of the healthy side is(48.76?7.51)100?g/cm~3,the affected side is significantly higher than the healthy side,the difference was statistically significant(P<0.05);the water(iodine)content of the affected side is(1093.94?16.11)1000 mg/cm~3,and the water(iodine)content of the healthy side is(1089.00?16.48)1000 mg/cm~3,there was no were not statistically significant(P=0.489>0.05).Conclusion:CT gemstone spectral-perfusion"one-stop"imaging method can effectively reflect the hemodynamic changes of the femoral head in patients with FNF.The substance separation function of the gemstone spectrum imaging is superior to the BV and BF of CT perfusion imaging in reflecting the contrast agent content in the tissue;The CT perfusion imaging TTP and MTT are superior to the energy spectrum imaging in reflecting the velocity of blood flow.The combination of the two can effectively reflect the hemodynamic changes of the femoral head in patients with FNF,and provide a new method for clinical to select a suitable surgical method.