本文選題：髁間窩 + MRI�。� 參考：《昆明醫(yī)科大學》2012年碩士論文

【摘要】：第一部分、MRI影像下股骨髁間窩三維數字化解剖與實體解剖測量值的對比研究 [目的] 隨著計算機輔助技術和數字化解剖學的發(fā)展,通過建立股骨髁間窩的數字化解剖模型,可為髁間窩的解剖學研究提供新的路徑。故本研究基于MRI影像下建立尸體股骨髁間窩三維數字化模型測量其解剖數據,并與尸體股骨髁間窩實體解剖數據比較,探討基于MRI影像下重建股骨髁間窩三維數字化模型的準確性及可靠性。 [方法] 1、對18側男性、14側女性新鮮冰凍膝關節(jié)尸體標本進行MR掃描獲取二維圖像。把MR二維圖像導入Mimics軟件中對股骨髁間窩進行三維重建,分別測量三維數字化模型的髁間窩寬度(ICW)、兩髁寬度(ECW)、髁間窩高度(ICH)、髁間窩頂的寬度(BLL)、股骨外髁的寬度(LCW)、股骨內髁的寬度(MCW)、外側髁的前后徑(SLLC)、內側髁的前后徑(SLMC)、股骨外髁傾角(ALC)、股骨內髁傾角(AMC),以上數據為三維重建組。 2、對18側男性、14側女性新鮮冰凍膝關節(jié)尸體標本進行實體解剖,分別測量實體股骨髁間窩寬度(ICW)、兩髁寬度(ECW)、髁間窩高度(ICH)、髁間窩頂的寬度(BLL)、股骨外髁的寬度(LCW)、股骨內髁的寬度(MCW)、外側髁的前后徑(SLLC)、內側髁的前后徑(SLMC)、股骨外髁傾角(ALC)、股骨內髁傾角(AMC),以上數據為實體組。 3、運用SPSS Statistics17.0統(tǒng)計學軟件進行分析,兩組數據及比值均數比較采用配對樣本t檢驗,以α=0.05作為檢驗標準。 [結果] 1、男性三維重建組和實體組的ECW, ICH. BLL、LCW、MCW、 SLLC、SLMC、ALC、AMC比較均無差異(p0.05)、髁間窩指數無差異(p0.05)。 2、女性三維重建組和實體組的ICW、ECW、ICH、BLL、LCW、MCW、 SLLC、SLMC、ALC. AMC比較均無差異(p0.05)、髁間窩指數無差異(p0.05)。 [結論] 基于MRI影像下股骨髁間窩的三維數字化模型能夠準確反映實體標本解剖信息,可用于正常人股骨髁間窩的解剖學研究,并對髁間窩相關疾病診治、交叉韌帶重建術具有重要的指導意義。 第二部分、基于MRI影像下股骨髁間窩的數字化解剖學研究 [目的] 隨著計算機輔助技術和數字化解剖學的發(fā)展,通過建立股骨髁間窩的數字化解剖模型并對其進行解剖學研究成為重要的研究方法之一,為髁間窩的解剖學研究提供了新的路徑。通過基于健康成人膝關節(jié)MR二維影像對股骨髁間窩的三維重建,研究股骨髁間窩的解剖形態(tài),以及對比其在性別方面和同體左右側的差別,探討虛擬化髁間窩成形術的臨床運用價值。 [方法] 1、對15例男性、15例女性健康受試者雙膝關節(jié)進行MR掃描獲取二維圖像,把MR二維圖像導入Mimics軟件中對股骨髁間窩進行三維重建獲得三維數字化模型,測量三維數字化模型的髁間窩寬度(ICW)、兩髁寬度(ECW)、髁間窩高度(ICH)、髁間窩頂的寬度(BLL)、股骨外髁的寬度(LCW)、股骨內髁的寬度(MCW),計算髁間窩寬度指數(NWI)及髁間窩形態(tài)指數(NSI)。 2、運用Mimics軟件對患者股骨髁間窩三維數字化模型進行虛擬化髁間窩成形術。 3、通過術中、術后評估髁間窩成形術后髁間窩和交叉韌帶的解剖關系。 4、運用SPSS17.0統(tǒng)計學軟件進行分析,男女股骨髁間窩數字化模型測量各項數據均數比較采用獨立樣本t檢驗,同體左右股骨髁間窩數字化模型測量各項數據均數比較采用配對樣本t檢驗,以α=0.05作為檢驗標準。 [結果] 1、男性與女性股骨髁間窩的三維數字化模型的ICW、ECW、ICH、BLL、 LCW、MCW皆具有顯著性差異(P0.05),NWI和NSI無顯著性差異(P0.05)。 2、男性及女性左右股骨髁間窩三維數字化模型的ICW、ECW、ICH、BLL、 LCW、MCW、NWI、NSI均無顯著性差異(P0.05)。 3、ACL重建術中參照術前虛擬切除骨量進行髁間窩成形,術中觀察重建韌帶在膝關節(jié)過伸位上剛好接近髁間窩頂壁及側壁,術后3月重建膝關節(jié)三維數字化模型發(fā)現(xiàn)重建的交叉韌帶與髁間窩無撞擊。 [結論] 男性與女性髁間窩解剖形態(tài)顯著性差異,NWI及NSI無差異；同體左右股骨髁間窩各測量指標無顯著性差異；髁間窩指數是反映髁間窩狹窄程度的指標之一,有利于指導髁間窩成形術；虛擬髁間窩成形術具有可行性,它可為前交叉韌帶重建術中髁間窩成形提供術前參考,具有一定的臨床指導意義。
[Abstract]:The first part is a comparative study of three-dimensional digital anatomy and solid anatomic measurements of femoral intercondylar fossa under MRI images.
[Objective]
With the development of computer aided and digital anatomy, the digital anatomical model of the intercondylar fossa of the femur can provide a new path for the anatomical study of the intercondylar fossa. Therefore, a three-dimensional digital model of the intercondylar fossa of the cadaver femur is established on the basis of MRI images to measure the anatomical data of the intercondylar fossa and the solid solution of the intercondylar fossa of the cadaver femur. The accuracy and reliability of three-dimensional digital reconstruction of femoral intercondylar fossa based on MRI images were compared.
[method]
1, 18 sides of male and 14 sides of fresh frozen knee joint specimens were scanned for two-dimensional images by MR. MR two-dimensional images were introduced into Mimics software for three-dimensional reconstruction of the femoral intercondylar fossa. The width of the intercondylar fossa (ICW), the width of the condyle (ECW), the intercondylar fossa height (ICH), the width of the intercondylar fossa (BLL), the femur (BLL), and the femur of the femur were measured. The width of the outer condyle (LCW), the width of the femoral condyle (MCW), the anterior and posterior diameter of the lateral condyle (SLLC), the anterior and posterior diameter of the medial condyle (SLMC), the obliquity of the femoral condyle (ALC) and the femoral internal condyle inclination (AMC), the above data are the three dimensional reconstruction group.
2, 14 sides of 18 men and 14 sides of fresh frozen knee joint specimens were dissected. The width of the femoral intercondylar fossa (ICW), the width of the two condyle (ECW), the height of the intercondylar fossa (ICH), the width of the intercondylar fossa (BLL), the width of the femoral condyle (LCW), the width of the femoral condyle (MCW), the anterior and posterior diameter of the lateral condyle (SLLC), and the anterior and posterior diameter of the medial condyle (SLMC). ) the external femoral condyle angle (ALC) and the medial femoral condyle angle (AMC).
3, using SPSS Statistics17.0 statistical software for analysis, two groups of data and ratios were compared using paired sample t test, with alpha =0.05 as the test standard.
[results]
1, there was no difference in ECW, ICH. BLL, LCW, MCW, SLLC, SLMC, ALC, AMC between male three dimensional reconstruction group and physical group (P0.05), and there was no difference in intercondylar fossa index (P0.05).
2, there was no difference in the ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC. AMC between the three dimensional reconstruction group and the entity group (P0.05). There was no difference in the intercondylar fossa index (P0.05).
[Conclusion]
The three-dimensional digital model of the femoral intercondylar fossa based on MRI image can accurately reflect the anatomical information of the solid specimen, and can be used in the anatomical study of the intercondylar fossa of the normal human femur, and it has important guiding significance for the diagnosis and treatment of the intercondylar fossa related diseases and the reconstruction of the cruciate ligament.
The second part is a digital anatomical study of the femoral intercondylar fossa based on MRI images.
[Objective]
With the development of computer aided and digital anatomy, the digital anatomical model of the intercondylar fossa and the anatomical study of the intercondylar fossa have become one of the most important research methods. A new path for the anatomical study of the intercondylar fossa is provided. A three-dimensional MR image of the knee joint of a healthy adult's knee is applied to the three-dimensional intercondylar fossa of the femur. To study the anatomical morphology of the intercondylar fossa of the femur, and to compare the difference between the sex and the left and right sides of the intercondylar fossa, and to discuss the clinical value of the virtual intercondylar fossa.
[method]
1, in 15 male and 15 female healthy subjects, two knee joints were scanned by MR to obtain two-dimensional images. The MR two-dimensional images were introduced into the Mimics software for three-dimensional reconstruction of the intercondylar fossa of the femur. The width of the intercondylar fossa (ICW), the width of the condyle (ECW), the intercondylar fossa height (ICH), the width of the intercondylar nests were measured. The width of the external condyle (LCW), the width of the medial condyle of the femur (MCW), the intercondylar notch width index (NWI) and the intercondylar notch morphology index (NSI) were calculated (BLL).
2, virtual intercondylar fossa plasty was performed by using Mimics software to digitize the femoral intercondylar fossa.
3, the anatomical relationship between the intercondylar fossa and the cruciate ligament after intercondylar fossa plasty was evaluated by intraoperative and postoperative evaluation.
4, the SPSS17.0 statistics software was used to analyze the digital model of the intercondylar fossa of the femur of men and women. The data were compared by independent sample t test. The data of the digital model of the intercondylar intercondylar fossa were compared with the paired sample t test, and alpha =0.05 was used as the test standard.
[results]
1, the ICW, ECW, ICH, BLL, LCW and MCW of femur intercondylar fossa of male and female have significant difference (P0.05), NWI and NSI have no significant difference (P0.05).
2, there were no significant differences in ICW, ECW, ICH, BLL, LCW, MCW, NWI and NSI between male and female femur intercondylar fossa models (P0.05).
3, during the reconstruction of ACL, the virtual resection of the bone volume was used for the reconstruction of the intercondylar fossa. The reconstruction of the ligament was just close to the top and lateral wall of the intercondylar fossa in the hyperextension of the knee. The reconstruction of the cruciate ligament and the intercondylar fossa had no impact on the reconstruction of the knee joint in March.
[Conclusion]
There is significant difference in the anatomical morphology of the intercondylar fossa between male and female. There is no difference between NWI and NSI, and there is no significant difference in the measurement indexes of the intercondylar fossa of the left and right femur. The intercondylar nest index is one of the indexes reflecting the stenosis degree of the intercondylar fossa, which is helpful to guide the intercondylar fossa plasty, and the virtual intercondylar fossa formation is feasible and it can be a anterior cruciate ligament. Reconstruction of intercondylar fossa formation provides preoperative reference and has certain clinical guiding significance.

【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R322.7

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