枕頸復(fù)合體關(guān)節(jié)間隙在不同影像中的比較研究及其臨床意義
發(fā)布時(shí)間：2018-10-22 07:27
【摘要】：目的通過火棉膠微視斷層切片測(cè)量和評(píng)估枕寰樞結(jié)構(gòu)的關(guān)節(jié)間隙,將火棉膠微視斷層切片相關(guān)結(jié)構(gòu)測(cè)量數(shù)值與CT、MRI的對(duì)應(yīng)數(shù)值進(jìn)行比較,探討CT、MRI對(duì)枕頸部關(guān)節(jié)間隙數(shù)據(jù)測(cè)量的精確性,明確枕頸復(fù)合體測(cè)量評(píng)估的最佳方法。 方法①采用12例正常死亡的成人尸體,取其頭頸部,標(biāo)本要求為中立位,無頸部疾病,以枕頸復(fù)合體作為觀測(cè)對(duì)象。②先將標(biāo)本進(jìn)行CT、MRI橫斷面掃描,層間距為1mm,利用Efilm軟件進(jìn)行矢狀位和冠狀位的圖像重建采集影像學(xué)圖像。③然后經(jīng)改良火棉膠包埋法處理標(biāo)本,分別修塊,脫鈣、沖水、酒精梯度脫水、梯度火棉膠浸膠、包埋,整合德國產(chǎn)浸酒L型切片機(jī),制備枕頸復(fù)合體的橫斷面(4例)、冠狀面(4例)和矢狀面(4例)的連續(xù)切片,層厚1mm。④取相互匹配的層面,觀察并測(cè)量分析三種來源圖像中的相關(guān)組織間隙。標(biāo)本切片用解剖鏡直接觀察；CT、MRI使用Efilm軟件進(jìn)行測(cè)量。測(cè)量精度精確到0.01cm。 結(jié)果在火棉膠組織切片、CT、MRI中精確測(cè)量枕頸復(fù)合體各關(guān)節(jié)間隙的距離。選擇評(píng)估枕頸復(fù)合體中最常用關(guān)節(jié)間隙,包括寰齒間隙(ADI)、齒突側(cè)塊間隙(LADI)、寰枕間隙(AOI)、寰樞椎間隙(AAI)、基底寰椎間隙(BAI)、基底齒突間隙(BDI)的距離,得出精確數(shù)據(jù)。得出3組數(shù)據(jù)后,利用spss軟件將三組數(shù)據(jù)進(jìn)行比較、統(tǒng)計(jì)學(xué)分析。經(jīng)過統(tǒng)計(jì)學(xué)處理,統(tǒng)計(jì)結(jié)果無顯著性差異。 結(jié)論①火棉膠微視斷層組織切片具有良好的組織固定穩(wěn)定性,測(cè)量數(shù)據(jù)最接近正常人體數(shù)據(jù),得出數(shù)據(jù)如下：ADI3.1250±0.91613mm, LLADI6.0875±1.01621mm, RLADI5.6250±1.65422mm, LAOI2.6167±0.47258mm, RAOI2.5583±0.38954mm, LAAI2.4625±0.49262mm, RAAI2.6625±0.75012mm, BDI4.2250±1.21209mm, BAI0.4750±1.42449mm。正常枕頸復(fù)合體的間隙測(cè)量數(shù)據(jù),可以為臨床和基礎(chǔ)研究提供精確的關(guān)節(jié)間隙數(shù)據(jù)以供參考。②結(jié)果提示火棉膠組織切片、CT、MRI中枕頸復(fù)合體各關(guān)節(jié)間隙的測(cè)量數(shù)據(jù)無統(tǒng)計(jì)學(xué)差異,可認(rèn)為CT、MRI均可作為判定枕頸復(fù)合體關(guān)節(jié)間隙的準(zhǔn)確方法,并且可以認(rèn)為CT、MRI可以準(zhǔn)確反映骨組織的影像,可以用CT、MRI任何一種方法進(jìn)行骨組織相關(guān)的在體研究。③MRI對(duì)軟組織,尤其是韌帶的顯影是其他影像學(xué)手段所不能比擬的,結(jié)合這個(gè)有點(diǎn),所以認(rèn)為MRI是評(píng)估枕頸復(fù)合體的最佳選擇方法。
[Abstract]:Objective to measure and evaluate the joint space of occipitocatlantoaxial structure by using the flint gel microview section, and compare the relative structure measurement value of the occipital atlantoaxial structure with the corresponding value of CT,MRI. To investigate the accuracy of CT,MRI in measuring the space between occipitocervical joints and to determine the best method for evaluating occipitocervical complex. Methods 1Twelve adult cadavers with normal death were taken from their heads and necks. The specimens required to be neutral and without neck disease. Occipitocervical complex was used as the observation object. (2) the specimens were scanned by CT,MRI cross-sectional scanning. The image reconstruction of sagittal and coronal position was carried out by Efilm software. 3. The specimens were treated with modified clove embedding method, and the specimens were repaired, decalcified, flushed, alcohol gradient dehydrated, and gradified sponge gum soaked respectively, and the results were as follows: (1) the interval between layers was 1 mm, and the images were reconstructed in sagittal and coronal position by Efilm software. The lamellar thickness 1mm.4 was used to match the cross section (4 cases), coronal plane (4 cases) and sagittal plane (4 cases) of the occipitocervical complex. To observe and measure the tissue gaps in the three source images. The specimens were observed directly by anatomic microscope and CT,MRI was measured by Efilm software. The precision of measurement is 0. 01 cm. Results the distance between the joints of occipitocervical complex was accurately measured by CT,MRI. To evaluate the distance of the most commonly used joint space in occipitocervical complex, including (ADI), lateral mass space, (LADI), occipital space, (AOI), space, (AAI), space, (BAI), basal space, (BDI) space, and obtain accurate data. After three groups of data were obtained, the three groups of data were compared by spss software, and the statistical analysis was made. There was no significant difference in the statistical results after statistical treatment. Conclusion\;\%? The measured data of the normal occipitocervical complex can provide accurate joint space data for clinical and basic research for reference. 2 the results suggest that there is no statistical difference between the measured data of the occipitocervical complex and the joint space in CT,MRI. It can be concluded that CT,MRI can be used as an accurate method to judge the space between occipitocervical complex and joint, and that CT,MRI can accurately reflect the image of bone tissue, and that CT,MRI can be used for in vivo study of bone tissue by any method of CT,MRI. Especially the development of ligaments can not be compared with other imaging methods, so MRI is the best method to evaluate occipitocervical complex.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R445.2;R816.8
[Abstract]:Objective to measure and evaluate the joint space of occipitocatlantoaxial structure by using the flint gel microview section, and compare the relative structure measurement value of the occipital atlantoaxial structure with the corresponding value of CT,MRI. To investigate the accuracy of CT,MRI in measuring the space between occipitocervical joints and to determine the best method for evaluating occipitocervical complex. Methods 1Twelve adult cadavers with normal death were taken from their heads and necks. The specimens required to be neutral and without neck disease. Occipitocervical complex was used as the observation object. (2) the specimens were scanned by CT,MRI cross-sectional scanning. The image reconstruction of sagittal and coronal position was carried out by Efilm software. 3. The specimens were treated with modified clove embedding method, and the specimens were repaired, decalcified, flushed, alcohol gradient dehydrated, and gradified sponge gum soaked respectively, and the results were as follows: (1) the interval between layers was 1 mm, and the images were reconstructed in sagittal and coronal position by Efilm software. The lamellar thickness 1mm.4 was used to match the cross section (4 cases), coronal plane (4 cases) and sagittal plane (4 cases) of the occipitocervical complex. To observe and measure the tissue gaps in the three source images. The specimens were observed directly by anatomic microscope and CT,MRI was measured by Efilm software. The precision of measurement is 0. 01 cm. Results the distance between the joints of occipitocervical complex was accurately measured by CT,MRI. To evaluate the distance of the most commonly used joint space in occipitocervical complex, including (ADI), lateral mass space, (LADI), occipital space, (AOI), space, (AAI), space, (BAI), basal space, (BDI) space, and obtain accurate data. After three groups of data were obtained, the three groups of data were compared by spss software, and the statistical analysis was made. There was no significant difference in the statistical results after statistical treatment. Conclusion\;\%? The measured data of the normal occipitocervical complex can provide accurate joint space data for clinical and basic research for reference. 2 the results suggest that there is no statistical difference between the measured data of the occipitocervical complex and the joint space in CT,MRI. It can be concluded that CT,MRI can be used as an accurate method to judge the space between occipitocervical complex and joint, and that CT,MRI can accurately reflect the image of bone tissue, and that CT,MRI can be used for in vivo study of bone tissue by any method of CT,MRI. Especially the development of ligaments can not be compared with other imaging methods, so MRI is the best method to evaluate occipitocervical complex.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R445.2;R816.8
【參考文獻(xiàn)】
相關(guān)期刊論文 前8條
1 鞏騰;楊慧;李云生;馮世慶;;脊柱胸腰段薄層斷層解剖及臨床意義[J];解剖與臨床;2008年03期
2 張?zhí)K;陳永珍;朱e，
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