三维数字化重建技术在156例胫骨近端形态学研究中的应用

The Application of Three-Dimensional Digitizing Reconstruction Technique in the Morphology Research of People's Proximal Tibia

目的应用计算机辅助建模技术获取健康成人正常胫骨近端截面相关参数的数值,进行统计学分析,为胫骨假体设计适合不同人种及胫骨平台骨折的临床治疗提供参考依据。方法随机选取健康志愿者156例,行双侧膝关节螺旋CT扫描,将DICOM格式的原始连续图像资料传入Mimics10.1软件建立国人膝关节胫骨近端三维重建,并对数字化模型进行形态学解剖参数的测量;根据性别、不同截骨位置、体重指数分组,探讨性别、不同截骨位置、体重指数对胫骨平台形态学的影响。结果从不同性别胫骨近端各参数测量结果可以看出男性所测量的参数均值大于女性;仅在胫骨平台前后径与胫骨平台横径比值女性略大于男性;胫骨平台截骨深度在6、12 mm截骨面的内外侧前后径的数值有统计学意义,截骨深度在9 mm为截骨面的内外侧前后径没有统计学意义;在各截骨面,前后径/横径比值据有统计学意义;对不同体重指数的组间情况进行分析可以得出三组胫骨内侧平台前后径、横径组间有统计学差异(P<0.05),对三组胫骨平台前后径/胫骨平台横径的比值进行分析,组间差异无统计学意义(P>0.05)。结论三维数字化重建技术在国人胫骨近端形态学与性别、体重、截骨深度等因素有相关性,该技术可为假体设计更加接近国人正常的膝关节形态提供参考。

Objective To provide a reference basis for designing prosthesis to fit different ethnic races and the clini- cal treatment of tibial plateau fracture, by applying computer - aided modeling technology to get related parameter values of healthy adults＇ normal proximal tibial section and conducting statistical analysis. Methods 156 healthy volunteers were randomly selected to take bilateral knee spiral CT scan in the supine position. The original continuous images of DICOM were introduced into Mimics10. 1 software to establish three -dimensional reconstruction of people＇s proximal tibial knee, and then the digital model was measured in parameters of morphological anatomy; body mass index on tibial plateau mor- phology was discussed according to gender, different cut bone position, body mass index group, the influence of sex, differ- ent osteotomies position. Results It can be concluded that men＇s parameter mean value was greater than women＇s, women were slightly larger than men only in tibial plateau anteroposterior diameter and tibial plateau diameter, there is statistical significance in osteotomies tibial plateau of 6 mm, 12 mm depth inside and outside of anteroposterior diameter, but no sta- tistical significance in 9 mm depth, there was statistical significance in anteroposterior diameter / transverse diameter ratio, after analyzing groups of different body mass index, it can be concluded that there was statistical significance in tibial an- teroposterior platform diameter and transverse diameter of three groups （P 〈 0. 05） , but no statistical significance in tibial plateau anteroposterior diameter / transverse diameter （ P 〉 0.05）. Conclusion Three - dimensional digitizing recon- struction technique had connection with the proximal tibial people with sex, weight and morphology of bone cutting depth, therefore the technology can provide the reference for false body design more close to normal people of the knee joint.