正常成人胸锁关节的16层螺旋CT测量研究

Study of 16-multidetector computed tomography in measurement of sternoclavicular articulation in normal adults

目的探讨16层螺旋CT对正常成人胸锁关节结构的显示与测量价值。方法对115例受检者分别进行正常解剖位和双侧上肢上举位胸锁关节CT扫描,对其中符合测量条件的100例扫描所得图像进行薄层重建,并进行三维、二维多平面重组(MPR)处理,测量两侧胸锁关节间距和胸骨关节面角度。采用t检验评价双侧关节的变化,并得出正常参考值范围。结果双侧胸锁关节上举位下胸骨关节面冠状位及横轴位关节面角度分别为:冠状位左侧(133.77±6.19)°、右侧(133.58±6.14)°;横轴位左侧(128.48±5.77)°、右侧(128.38±5.99)°。其关节间距分别为:冠状位左侧(7.19±1.23)mm、右侧(7.23±1.24)mm;横轴位左侧(7.44±1.20)mm、右侧(7.43±1.23)mm。双侧胸锁关节解剖位关节间距分别为:冠状位左侧(6.19±1.13)mm、右侧(6.20±1.13)mm;横轴位左侧(6.83±1.05)mm、右侧(6.83±1.04)mm。比较相同体位下两侧胸锁关节间距及角度正常参考值,两者之间差异无统计学意义(P>0.05);在不同体位下,两侧胸锁关节间距存在统计学差异(P<0.01)。结论 16层螺旋CT可重组显示与测量胸锁关节结构,其正常测量值的建立对胸锁关节变异与疾病的诊疗评估有一定的参考作用。

Objective To study the value of 16-multidetector-row computed tomography（MDCT） in display and measurement of sternoclavicular articulation in normal adults.Methods The data of 100 cases with good imaging quality in 115 cases underwent 16-MDCT of sternoclavicular articulation under the positions of normal anatomy and of lifting of bilateral upper limbs were reconstructed by three-dimension（3D） and two-dimension（2D） post-processing.The sternoclavicular articulation spacings and sternal articular surface angles were measured on both sides.t-test was used to compare the changes of bilateral sides and different positions.Results Under the position of lifting bilateral upper limbs,the sternal articular surface angles of coronal and horizontal axis of a joint were as follows： Left coronal axis（133.77±6.19） °,right coronal axis（133.58±6.14） °,left horizontal axis（128.48±5.77） °,and right horizontal axis（128.38±5.99） °.The sternoclavicular articulation spacings were as follows： Left coronal axis（7.19±1.23） mm,right coronal axis（7.23±1.24） mm,left horizontal axis（7.44±1.20） mm,and right horizontal axis（7.43±1.23） mm.Under the position of normal anatomy of sternoclvicle articulation,the sternoclavicular articulation spacings were as follows： Left coronal axis（6.19±1.13） mm,right coronal axis（6.20±1.13） mm,left horizontal axis（6.83±1.05） mm,and right horizontal axis（6.83±1.04） mm.There were no significant differences in bilateral sternoclavicular articulation spacings and angles under the same position（P0.05）.There were significant differences in articulation spacings between different positions（P0.01）.Conclusion 16-MDCT was very useful in the reconstruction and display of sternoclavicular articulation,which can establish a normal reference and assess the treatment of diseases.