数字化技术辅助的中国人髋臼朝向三维测量

Digital technique assisted three-dimensional measurement of acetabular orientation for Chinese people

目的·开发一种精确可靠的三维测量技术,实现国人髋臼朝向的三维测量。方法·筛选60例(男女各30例)因非骨科疾患行双下肢CT扫描患者,获取CT数据,自主开发软件,验证其精确性和可靠性,实现骨盆三维建模,手工选点、迭代优化骨盆三维坐标系,基于模型表面实现髋臼参数的半自动测量,并描述中国人髋臼形态特征。结果·基于三维模型的髋臼测量技术有极好的可靠性(相关系数>0.999)和精确性。男女性相比,女性髋臼前倾角显著大于男性(平均3.1°,95%CI 2.0°~4.2°,P=0.004),解剖学外展角亦显著大于男性(0.9°,95%CI 0.4°~1.4°,P=0.028)。髋臼朝向双侧对比差异无统计学意义,部分个体双侧存在差异,前倾角相差最大为9.1°,外展角最大相差5.7°。结论·髋臼朝向在男女性间比较差异有统计学意义(P<0.05);整体上髋臼朝向变异范围较大,尤其是前倾角;个体髋臼朝向基本呈双侧对称。髋臼的三维测量及分析有助于髋关节疾患的诊治及假体设计。

Objective·To develop a reliable and accurate 3D acetabular orientation measurement method for Chinese people.Methods·CT data of 60(30 males and 30 females) adult patients with disease irrelevant to bones were collected.3D models of osseous pelves were generated and the 3D coordinates of osseous pelves were manually selected and optimized via iterations.A surface-based method was used to realize semi-automatic measurement of acetabular spatial parameters and describe acetabular characteristics of Chinese people.A software was developed to verify the accuracy and reliability of this method.Results·3D model based acetabular measurement method was quite reliable(intraclass correlation coefficient[ICC]> 0.999) and accurate.Both anteversion(average:3.1°,95% CI 2.0°-4.2°,P = 0.004) and anatomic inclination(0.9°,95% CI 0.4°-1.4°,P = 0.028) of females were greater than those of males.There was no significant difference in bilateral acetabular orientation.However,bilateral differences in anteversion(maximum 9.1°) and inclination(maximum 5.7°) were observed in some individuals.Conclusion·Differences in acetabular orientation between males and females were statistically significant(P < 0.05).The variation ranges of acetabular orientation were wide,especially the anteversion.Individual acetabular orientation was relatively symmetrical.3D acetabular measurement and analysis are helpful for the diagnosis and treatment of hip disease and the design of prosthesis.