骨盆CT三维重建下髋臼形态的初步研究

Morphologic features of acetabulum under CT three-dimensional reconstruction

目的探讨CT三维重建下髋臼形态测量的结果及其临床意义。方法用Phillip Brilliance 64层CT对69例无髋关节疾病的受试者进行骨盆连续扫描,利用CT的计算机工作站进行骨盆结构的三维重建,并测量计算髋臼上下径(suprainferior diameter,SID)、外展角(abduction angle,ABA)、前后径(anteroposterior diameter,APD)、前倾角(anteversion angle,AVA)以及SID/APD比值。比较不同性别、左右侧间的差异。结果69例受试者髋臼的ABA为41.00°±3.94°;AVA为11.63°±3.91°;SID为(59.03±3.73)mm;APD为(54.45±3.68)mm;SID/ APD比值为1.135±0.069,其中男性1.14±0.06,女性1.13±0.07。男性受试者的SID和APD明显大于女性(P<0.001),且SID明显大于APD,但SID/APD比值,以及ABA和AVA在不同性别受试者间无明显差异(P>0.05)。两侧髋臼的ABA、AVA、SID、APD以及SID/APD比值均无明显差异(P>0.05)。结论CT三维重建能够方便准确地测量髋臼形态。髋臼方向在不同性别和左右侧间无明显差别;男性髋臼大于女性,但左右侧间无明显差别。研究髋臼方向和大小对全髋关节置换的术前准备和和术中操作有重要指导意义。

Objective To probe the clinical significance of CT three-dimensional reconstruction for measuring the morphologic features of aeetabulum. Methods Totally 69 subjects were enrolled in this study, including 35 males and 34 females. CT scanning was performed and their pelvis three-dimensional structure were reconstructed in CT computer work-station. Acetabulum orientation and size were measured by CT computer measurement tools. Results The average abduction angle was 41.00°±3.94°, the average anteversion angle was 11.63°±3.91°, the average supra-inferior diameter was （59.03±3.73） mm, and the average anteroposterior diameter was （54.45±3.68） mm. The average rate of suprainferior diameter and anteroposterior diameter was 1. 135±0.069. The average rate of suprainferior diameter and anteroposterior of males was 1.14±0. 06. The average rate of suprainferior diameter and anteroposterior females was 1.13±0. 07. There were no significant differences between males and females regarding abduction angle and anteversion angle （ P 〉 0. 05 ）. Suprainferior diameter and anteroposterior diameter were significantly larger in males than in females （ P 〈 0. 001 ）. The rate of suprainferior diameter and anteroposterio diameter was not significantly different between male and fe- male （P 〉 0.05）. The right and left acetabulum orientation and size did not have significant differences （P 〉 0. 05）. Acetabular suprainferior diameter was remarkably larger than anteroposterio diameter. The left rate of suprainferior diameter and anteroposterior diameter was 1.16±0.07, the right rate of suprainferior diameter and anteroposterior diameter was 1.16±0.06 （P〉0.05）. Conclusion CT three-dimensional reconstruction is convenient and precise means in the study of morphologic features of acetabulum.