股骨髁間窩影像和解剖學研究及其臨床意義
發(fā)布時間：2018-07-14 07:50
【摘要】：目的:通過測量人體股骨骨骼標本髁間窩分析CT及X線與直接測量的差異;CT及X線測量經(jīng)關節(jié)鏡證實存在ACL慢性損傷患者的術前髁間窩指標,探討兩種方法預測髁間窩狹窄的可靠性及其臨床意義。方法:1.選取延邊大學解剖教研室提供的成人股骨完整標本69具。分別對標本股骨髁間窩進行直接測量,X線與CT拍攝后獲得的圖像上測量,獲得股骨髁間窩寬度(ICW)、髁間窩寬度指數(shù)(NWI)、股骨髁間窩寬度(髁間窩關節(jié)面邊緣)、股骨髁間窩寬度(髁間窩上2/3高度)、股骨髁寬度、髁間窩角,同時通過三種方法對髁間窩進行分型,比較CT及X線與直接測量的差異。2.選取延邊大學附屬醫(yī)院骨關節(jié)及運動醫(yī)學外科自2016年3月至2016年12月期間收治的單側在關節(jié)鏡下證實存在因髁間窩狹窄導致ACL慢性損傷者共90例。所有患者術前均拍攝CT及X線,在獲得的圖像上測量并計算髁間窩寬度(ICW)及髁間窩寬度指數(shù)(NWI),各組間的測量值與骨骼標本的標準值進行比較,同時對髁間窩分型并按性別差異進行對比。結果:1.骨骼標本測量中,直接測量和CT測量所有結果均無差異(P0.05),直接測量和X線測量結果除髁間窩寬度指數(shù)(NWI)外所有指標均有顯著差異(P0.05),三種方法的髁間窩分型完全一致。2.臨床病例測量中,CT:髁間窩寬度(ICW)為16.68±1.03mm,顯著低于標準值18.51mm(P0.05);髁間窩寬度指數(shù)(NWI)0.22±0.02,也顯著低于標準值0.24(P0.05)。X線:髁間窩寬度(ICW)為16.87±.05mm,顯著低于標準值19.18mm(P0.05);髁間窩寬度指數(shù)(NWI)0.22±0.02,顯著低于標準值0.24(P0.05)。根據(jù)NW I標準值和測量值,CT確定77例(86%)存在髁間窩狹窄;X線確定68例(76%)存在髁間窩狹窄。CT與關節(jié)鏡髁間窩分型一致,X線與前兩者略有差異。男女患者髁間窩分型有顯著差異,女性A型及W型髁間窩比例大于男性,男性U型髁間窩比例大于女性。結論:CT是測量股骨髁間窩及預測髁間窩狹窄比較可靠的影像學方法,X線雖然不如CT準確、立體,但仍具有一定的參考價值。影像學測量股骨髁間窩NWI及觀察髁間窩形態(tài)對預測ACL損傷風險具有重要的臨床意義。
[Abstract]:Objective: by measuring the differences of CT and X-ray and direct measurement in the intercondylar fossa of human femur bone specimens, CT and X-ray measurements confirmed the preoperative intercondylar fossa indexes of patients with ACL chronic injury by arthroscopy, and discussed the reliability and clinical significance of two methods for predicting the stenosis of intercondylar fossa. Methods: 1. select the anatomy teaching and Research Department of Yanbian University. 69 complete femoral femoral specimens. The intercondylar fossa of the femur was measured directly. The width of the intercondylar fossa (ICW), the width index of the intercondylar fossa (NWI), the width of the intercondylar fossa (intercondylar fossa's surface edge), the width of the femoral intercondylar fossa (the 2/3 height on the intercondylar fossa), the width of the femoral condyle, the intercondylar intercondylar, and the width of the condyle fossa of the femur were measured by X-ray and CT images. At the same time, three methods were used to classify the intercondylar fossa, and the differences of CT and X-ray and direct measurement were compared..2. selected from March 2016 to December 2016 of the Affiliated Hospital of Yanbian University confirmed that there were 90 cases of chronic ACL injury caused by the narrowing of the intercondylar fossa. CT and X ray were taken before the operation. The width of the intercondylar fossa (ICW) and the intercondylar fossa width index (NWI) were measured and calculated on the obtained images. The measured values between each group were compared with the standard values of the bone specimens. At the same time, the intercondylar fossa was divided and the sex differences were compared. Results: 1. bone specimens were measured, and all the results were measured by direct and CT measurements. The difference (P0.05), the results of the direct and X-ray measurements were significantly different (P0.05) except the intercondylar width index (NWI). The intercondylar fossa width (ICW) of the three methods was 16.68 + 1.03mm, significantly lower than the standard 18.51mm (P0.05), and the intercondylar fossa width index (NWI) was 0.22 + 0.02 in the.2. clinical case measurement. Significantly lower than standard value 0.24 (P0.05). X: the width of the intercondylar fossa (ICW) was 16.87 +.05mm, significantly lower than the standard value 19.18mm (P0.05); the intercondylar fossa width index (NWI) was 0.22 + 0.02, significantly lower than the standard value 0.24 (P0.05). According to NW I standard value and measured value, CT confirmed 77 cases (86%) had intercondylar fossa stenosis; X-ray confirmed 68 cases (76%) had intercondylar fossa stenosis.CT and The intercondylar fossa of arthroscopy was the same. There was a slight difference between the X - ray and the former two. There were significant differences in the intercondylar fossa of male and female patients. The proportion of female A type and W type intercondylar fossa was greater than that of men, and the proportion of male U intercondylar fossa was greater than that of women. Conclusion: CT is a reliable imaging method for measuring the intercondylar fossa of the femur and predicting the stenosis of intercondylar fossa, although the X ray is not as accurate as CT, Stereoscopic, but still of certain reference value, imaging measurement of NWI and observing the shape of intercondylar fossa in femoral intercondylar fossa is of great clinical significance in predicting the risk of ACL injury.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687;R322
本文編號：2120963
[Abstract]:Objective: by measuring the differences of CT and X-ray and direct measurement in the intercondylar fossa of human femur bone specimens, CT and X-ray measurements confirmed the preoperative intercondylar fossa indexes of patients with ACL chronic injury by arthroscopy, and discussed the reliability and clinical significance of two methods for predicting the stenosis of intercondylar fossa. Methods: 1. select the anatomy teaching and Research Department of Yanbian University. 69 complete femoral femoral specimens. The intercondylar fossa of the femur was measured directly. The width of the intercondylar fossa (ICW), the width index of the intercondylar fossa (NWI), the width of the intercondylar fossa (intercondylar fossa's surface edge), the width of the femoral intercondylar fossa (the 2/3 height on the intercondylar fossa), the width of the femoral condyle, the intercondylar intercondylar, and the width of the condyle fossa of the femur were measured by X-ray and CT images. At the same time, three methods were used to classify the intercondylar fossa, and the differences of CT and X-ray and direct measurement were compared..2. selected from March 2016 to December 2016 of the Affiliated Hospital of Yanbian University confirmed that there were 90 cases of chronic ACL injury caused by the narrowing of the intercondylar fossa. CT and X ray were taken before the operation. The width of the intercondylar fossa (ICW) and the intercondylar fossa width index (NWI) were measured and calculated on the obtained images. The measured values between each group were compared with the standard values of the bone specimens. At the same time, the intercondylar fossa was divided and the sex differences were compared. Results: 1. bone specimens were measured, and all the results were measured by direct and CT measurements. The difference (P0.05), the results of the direct and X-ray measurements were significantly different (P0.05) except the intercondylar width index (NWI). The intercondylar fossa width (ICW) of the three methods was 16.68 + 1.03mm, significantly lower than the standard 18.51mm (P0.05), and the intercondylar fossa width index (NWI) was 0.22 + 0.02 in the.2. clinical case measurement. Significantly lower than standard value 0.24 (P0.05). X: the width of the intercondylar fossa (ICW) was 16.87 +.05mm, significantly lower than the standard value 19.18mm (P0.05); the intercondylar fossa width index (NWI) was 0.22 + 0.02, significantly lower than the standard value 0.24 (P0.05). According to NW I standard value and measured value, CT confirmed 77 cases (86%) had intercondylar fossa stenosis; X-ray confirmed 68 cases (76%) had intercondylar fossa stenosis.CT and The intercondylar fossa of arthroscopy was the same. There was a slight difference between the X - ray and the former two. There were significant differences in the intercondylar fossa of male and female patients. The proportion of female A type and W type intercondylar fossa was greater than that of men, and the proportion of male U intercondylar fossa was greater than that of women. Conclusion: CT is a reliable imaging method for measuring the intercondylar fossa of the femur and predicting the stenosis of intercondylar fossa, although the X ray is not as accurate as CT, Stereoscopic, but still of certain reference value, imaging measurement of NWI and observing the shape of intercondylar fossa in femoral intercondylar fossa is of great clinical significance in predicting the risk of ACL injury.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687;R322
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