CT图像和重组技术在骶椎临床影像解剖学研究中的应用

Application of CT image and reconstruction technique in clinical imaging anatomy of sacral vertebra

目的观察骶椎的解剖形态及其与耻骨联合的位置关系,为骶椎正位X线摄影体位的优化设计提供解剖学依据。方法回顾性随机收集1000例患者骨盆腔CT影像,借助CT图像重组技术观测骶椎的解剖形态及其与耻骨联合的相对位置关系。结果骶椎均为前面凹陷、底朝上、尖向下后方走行,骶椎上下端中点连线M与人躯体长轴之间的夹角A均为锐角,耻骨联合位于骶椎的前正中偏下位置,其与骶椎下缘的连线N和躯体长轴垂线间夹角B>0°(即耻骨联合上缘低于骶椎下缘的位置)占89.7%(897/1000);青少年组(14~45岁)角A为(35.86±6.88)°,明显低于中年组(46~69岁)(37.82±6.34)°和老年组(>69岁)(37.60±6.65)°(P<0.05),青少年组角B为(10.27±7.02)°,明显高于中年组(8.88±7.23)°和老年组(7.83±6.93)°(P<0.05),而中年组和老年组间差异均无统计学意义;男性角A(36.12±0.27)°和角B(6.27±0.25)°,均明显低于女性(38.03±0.33)°和(12.79±0.33)°(P<0.05)。结论CT图像重组技术可用于观察和分析骶椎的解剖形态及其与耻骨联合的位置关系,不同年龄段和不同性别者骶椎与耻骨联合的相对位置情况差异显著,可为骶椎正位X线摄影检查体位的优化设计提供可靠的解剖学依据。

Objective To observe the anatomical morphology of the sacral vertebra and the position relationship between the sacral vertebra and the pubic symphysis,which provides anatomic basis for the optimal design of the anteroposterior radiography position of the sacral vertebra.Methods Pelvic CT images of existing patients were collected randomly.The anatomical morphology of sacral vertebra and its relative positionship with pubic symphysis were observed and analyzed by CT image reconstruction technique.Results The sacral vertebra was concave in front,the bottom was upward and the tip was backward and downward.The angle A,between the long axis of the human body and the line M formed by connecting the midpoint of the upper and lower edges of the sacral vertebra,was acute angle.The pubic symphysis was located at the lower position of the anterior middle of the sacral vertebra.The angle B,between the vertical line of the long axis of the human body and the line N formed by connecting the upper edge of the pubic symphysis and the lower edge of the lower sacral vertebra,was positive(that was,the position of the upper edge of the pubic symphysis was lower than the lower edge of the sacral vertebra)accounting for 89.7%of cases(897/1000).The measurement value of angle A in the adolescent group(14~45 years old)was(35.86±6.88)°,which was significantly lower than that in the middle-aged group(46~69 years old)(37.82±6.34)°and the elderly group(>69 years old)(37.60±6.65)°(P<0.05).The value of angle B in the adolescent group was(10.27±7.02)°,which was significantly higher than that in the middle-age group(8.88±7.23)°and the elderly group(7.83±6.93)°(P<0.05),and there was no significant difference between the middle-age group and the elderly group.The value of angle A(36.12±0.27)°and angle B(6.27±0.25)°in males were significantly lower than those in females(38.03±0.33)°and(12.79±0.33)°(P<0.05).Conclusions The CT image reconstruction technique can be used to observe and analyze the anatomical morphology of the sacral vertebra and its relative position with the pubic symphysis.The positional relationship of the sacral vertebra and pubic symphysis were significantly different in different ages and genders,which can provide a reliable anatomic basis for the optimal design of the radiography position of anteroposterior sacral vertebra.