基于CT三维重建肩胛下角的形态学分型特点及临床意义

Morphological classification and clinical significance of inferior angle of scapula based on CT three-dimensional reconstruction

目的探讨CT三维重建下的肩胛下角形态学分型特点及临床意义。方法采集290个肩胛骨三维重建影像资料,g是肩胛下角,n是盂下结节,m是肩胛冈与肩胛骨内侧缘交点,k是肩胛上角,r是肩胛冈盂切迹,h是g点到mr垂线的交点,观察肩胛下角形态学特点,并测量相关数据。测量g点最厚部分,gn、gm、gh的长度,∠ngm、∠gmk(肩胛骨在冠状面上的投影)、∠gmk’(肩胛骨在矢状面上的投影)的度数。结果CT三维重建图像显示,肩胛下角大体有3种类型:副角型(175,60.34%)、U型(81,27.93%)和V型(34,11.73%),此外,副角型的g点最厚部分及gn与V型差异有显著性(P<0.05);在gm上,副角型比U型和V型长(P<0.05);在gh上,V型比副角型和U型短(P<0.05);在∠gmk’上,副角型比U型大(P<0.05)。双侧肩胛下角在∠ngm上差异有显著性(P<0.05)。结论基于CT三维重建结果,将肩胛下角分为3种类型,以副角型为主,V型少见。

Objective To research the morphological classification of inferior angle of scapula based on CT 3 D reconstruction and its clinical significance.Methods A total of 290 scapular bones data were collected from People’s Hospital of Lu Xian County and measured based on CT 3 D reconstruction.The scapular bones images were reconstructed by CT 3 D technique.Reference points:g was the inferior scapular angle,n was the inferior glenotubular nodule,m was the intersection of the scapular ganglion and the medial edge of the scapula,k was the upper scapular angle,r was the notch of the scapular glenoid,h was the intersection of point g to mr.The parameters of inferior angles of 290 scapular bones,including the thickness of point g(the thickest part of inferior angle of the scapula),the length of the line gn,line gm,and line gh,and the angle of∠ngm,∠gmk(the projection of the scapular coronal plane),and∠gmk’(the projection of the scapular sagittal plane)were observed and measured by CT 3 D technique.Results Under the CT three-dimensional reconstruction,the inferior angle of scapula was classified into three types:accessory angle-type(175,60.34%),U-type(81,27.93%)and V-type(34,11.73%).In addition,there was a significant difference between the auxiliary angle type and theⅤtype on the thickest part of the g point and gn(P<0.05);U-type and V-type with paragonal gm-significant difference(P<0.05);There was a significant difference between the auxiliary angle type and the U shape on gh(P<0.05);there was a significant difference between the auxiliary angle type and the U shape on∠gmk’(P<0.05).There was a significant difference in the inferior angle of the bilateral scapula on mngm(P<0.05).Conclusion Based on the result of CT three-dimensional reconstruction,the inferior angle of scapulae have three anatomical types,with the accessory angle-type as the main type,and the morphology and classification of it are of certain clinical implication.