解剖学和影像学测量股骨头颈直径比的比较研究

Comparative study of measurement of femoral head and neck between anatomy and imaging

目的对60对股骨标本进行实际测量,以获得国人股骨头颈直径比的正常值,并且和影像学数据进行对比,为临床治疗提供参考。方法解剖组包括60对股骨标本,采用游标卡尺直接测量尸体标本解剖形态,测量股骨头颈直径比。影像组纳入自2010-01—2012-12摄骨盆正位X线片检查的600例患者,按Doherty法确定股骨头最大直径和股骨颈最小直径,分别测量这2个指标并计算其比例。结果解剖组的股骨头最大直径为(43.83±4.13)mm,股骨颈最小直径为(29.83±2.95)mm,股骨头颈直径比例为(1.47±0.08)。影像组的股骨头最大直径为(42.32±7.44)mm,股骨颈最小直径为(28.87±5.46)mm,股骨头颈直径比为(1.47±0.12)。解剖组和影像组股骨头最大直径的差异有统计学意义(t=2.68,P=0.01),股骨颈最小直径的差异无统计学意义(t=0.20,P=0.73),股骨头颈直径比例差异无统计学意义(t=-0.16,P=0.82)。结论应用标准方法测得的影像学数据可以直接用于临床研究髋关节骨性关节炎及撞击综合征的早期鉴别和诊断,股骨头颈直径比的测量对髋关节撞击综合征的诊断、分型以及异常影像征象的量化方面有重要意义。

Objective To obtain the normal femoral head-neck ratio and compare with imaging data to provide reference for clinical treatment. Methods Anatomical group included 60 of femoral specimen. The femoral head and neck were measured with Vernier caliper. The image group included 600 patients with regular checks on the pelvis during 2010-2012. Doherty＇s method was used to determine the biggest diameter of the femoral head and femoral neck minimum longitudinal size. The two indicators were measured and its proportion was calculated. Results The anatomy group＇s femoral head-neck ratio was（1.47±0.08）. The image group＇s femoral head-neck ratio was（1.47 ±0.12）. The anatomy group＇s maximum diameter of the femoral head was（43.83 ±4.13）mm. The image group＇s maximum diameter of the femoral head was（42.32 ±7.44）mm. The anatomy group＇s minimum diameter of femoral neck was（29.83 ±2.95）mm. The image group＇s minimum diameter of femoral neck was（28.87 ±5.46）mm. The distance of the diameter of the femoral head between these two groups had statistically significant difference（P〈0.05）. Conclusion The imaging data obtained by using the standard methods can be used in clinical study of early identification and diagnosis with hip osteoarthritis and impingement syndrome. The femoral head and neck ratio measurement has an important significance in the diagnosis and classification even the quantification of abnormal image signs of hip joint impingement syndrome.