MRI影像下股骨髁间窝的三维可视化研究

发布时间：2018-05-06 08:17

本文选题：髁间窝 + MRI　；参考：《昆明医科大学》2012年硕士论文

【摘要】：第一部分、MRI影像下股骨髁间窝三维数字化解剖与实体解剖测量值的对比研究 [目的] 随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型,可为髁间窝的解剖学研究提供新的路径。故本研究基于MRI影像下建立尸体股骨髁间窝三维数字化模型测量其解剖数据,并与尸体股骨髁间窝实体解剖数据比较,探讨基于MRI影像下重建股骨髁间窝三维数字化模型的准确性及可靠性。 [方法] 1、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行MR扫描获取二维图像。把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建,分别测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为三维重建组。 2、对18侧男性、14侧女性新鲜冰冻膝关节尸体标本进行实体解剖,分别测量实体股骨髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW)、外侧髁的前后径(SLLC)、内侧髁的前后径(SLMC)、股骨外髁倾角(ALC)、股骨内髁倾角(AMC),以上数据为实体组。 3、运用SPSS Statistics17.0统计学软件进行分析,两组数据及比值均数比较采用配对样本t检验,以α=0.05作为检验标准。 [结果] 1、男性三维重建组和实体组的ECW, ICH. BLL、LCW、MCW、 SLLC、SLMC、ALC、AMC比较均无差异(p0.05)、髁间窝指数无差异(p0.05)。 2、女性三维重建组和实体组的ICW、ECW、ICH、BLL、LCW、MCW、 SLLC、SLMC、ALC. AMC比较均无差异(p0.05)、髁间窝指数无差异(p0.05)。 [结论] 基于MRI影像下股骨髁间窝的三维数字化模型能够准确反映实体标本解剖信息,可用于正常人股骨髁间窝的解剖学研究,并对髁间窝相关疾病诊治、交叉韧带重建术具有重要的指导意义。第二部分、基于MRI影像下股骨髁间窝的数字化解剖学研究 [目的] 随着计算机辅助技术和数字化解剖学的发展,通过建立股骨髁间窝的数字化解剖模型并对其进行解剖学研究成为重要的研究方法之一,为髁间窝的解剖学研究提供了新的路径。通过基于健康成人膝关节MR二维影像对股骨髁间窝的三维重建,研究股骨髁间窝的解剖形态,以及对比其在性别方面和同体左右侧的差别,探讨虚拟化髁间窝成形术的临床运用价值。 [方法] 1、对15例男性、15例女性健康受试者双膝关节进行MR扫描获取二维图像,把MR二维图像导入Mimics软件中对股骨髁间窝进行三维重建获得三维数字化模型,测量三维数字化模型的髁间窝宽度(ICW)、两髁宽度(ECW)、髁间窝高度(ICH)、髁间窝顶的宽度(BLL)、股骨外髁的宽度(LCW)、股骨内髁的宽度(MCW),计算髁间窝宽度指数(NWI)及髁间窝形态指数(NSI)。 2、运用Mimics软件对患者股骨髁间窝三维数字化模型进行虚拟化髁间窝成形术。 3、通过术中、术后评估髁间窝成形术后髁间窝和交叉韧带的解剖关系。 4、运用SPSS17.0统计学软件进行分析,男女股骨髁间窝数字化模型测量各项数据均数比较采用独立样本t检验,同体左右股骨髁间窝数字化模型测量各项数据均数比较采用配对样本t检验,以α=0.05作为检验标准。 [结果] 1、男性与女性股骨髁间窝的三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW皆具有显著性差异(P0.05),NWI和NSI无显著性差异(P0.05)。 2、男性及女性左右股骨髁间窝三维数字化模型的ICW、ECW、ICH、BLL、 LCW、MCW、NWI、NSI均无显著性差异(P0.05)。 3、ACL重建术中参照术前虚拟切除骨量进行髁间窝成形,术中观察重建韧带在膝关节过伸位上刚好接近髁间窝顶壁及侧壁,术后3月重建膝关节三维数字化模型发现重建的交叉韧带与髁间窝无撞击。 [结论] 男性与女性髁间窝解剖形态显著性差异,NWI及NSI无差异；同体左右股骨髁间窝各测量指标无显著性差异；髁间窝指数是反映髁间窝狭窄程度的指标之一,有利于指导髁间窝成形术；虚拟髁间窝成形术具有可行性,它可为前交叉韧带重建术中髁间窝成形提供术前参考,具有一定的临床指导意义。
[Abstract]:The first part is a comparative study of three-dimensional digital anatomy and solid anatomic measurements of femoral intercondylar fossa under MRI images.
[Objective]
With the development of computer aided and digital anatomy, the digital anatomical model of the intercondylar fossa of the femur can provide a new path for the anatomical study of the intercondylar fossa. Therefore, a three-dimensional digital model of the intercondylar fossa of the cadaver femur is established on the basis of MRI images to measure the anatomical data of the intercondylar fossa and the solid solution of the intercondylar fossa of the cadaver femur. The accuracy and reliability of three-dimensional digital reconstruction of femoral intercondylar fossa based on MRI images were compared.
[method]
1, 18 sides of male and 14 sides of fresh frozen knee joint specimens were scanned for two-dimensional images by MR. MR two-dimensional images were introduced into Mimics software for three-dimensional reconstruction of the femoral intercondylar fossa. The width of the intercondylar fossa (ICW), the width of the condyle (ECW), the intercondylar fossa height (ICH), the width of the intercondylar fossa (BLL), the femur (BLL), and the femur of the femur were measured. The width of the outer condyle (LCW), the width of the femoral condyle (MCW), the anterior and posterior diameter of the lateral condyle (SLLC), the anterior and posterior diameter of the medial condyle (SLMC), the obliquity of the femoral condyle (ALC) and the femoral internal condyle inclination (AMC), the above data are the three dimensional reconstruction group.
2, 14 sides of 18 men and 14 sides of fresh frozen knee joint specimens were dissected. The width of the femoral intercondylar fossa (ICW), the width of the two condyle (ECW), the height of the intercondylar fossa (ICH), the width of the intercondylar fossa (BLL), the width of the femoral condyle (LCW), the width of the femoral condyle (MCW), the anterior and posterior diameter of the lateral condyle (SLLC), and the anterior and posterior diameter of the medial condyle (SLMC). ) the external femoral condyle angle (ALC) and the medial femoral condyle angle (AMC).
3, using SPSS Statistics17.0 statistical software for analysis, two groups of data and ratios were compared using paired sample t test, with alpha =0.05 as the test standard.
[results]
1, there was no difference in ECW, ICH. BLL, LCW, MCW, SLLC, SLMC, ALC, AMC between male three dimensional reconstruction group and physical group (P0.05), and there was no difference in intercondylar fossa index (P0.05).
2, there was no difference in the ICW, ECW, ICH, BLL, LCW, MCW, SLLC, SLMC, ALC. AMC between the three dimensional reconstruction group and the entity group (P0.05). There was no difference in the intercondylar fossa index (P0.05).
[Conclusion]
The three-dimensional digital model of the femoral intercondylar fossa based on MRI image can accurately reflect the anatomical information of the solid specimen, and can be used in the anatomical study of the intercondylar fossa of the normal human femur, and it has important guiding significance for the diagnosis and treatment of the intercondylar fossa related diseases and the reconstruction of the cruciate ligament.
The second part is a digital anatomical study of the femoral intercondylar fossa based on MRI images.
[Objective]
With the development of computer aided and digital anatomy, the digital anatomical model of the intercondylar fossa and the anatomical study of the intercondylar fossa have become one of the most important research methods. A new path for the anatomical study of the intercondylar fossa is provided. A three-dimensional MR image of the knee joint of a healthy adult's knee is applied to the three-dimensional intercondylar fossa of the femur. To study the anatomical morphology of the intercondylar fossa of the femur, and to compare the difference between the sex and the left and right sides of the intercondylar fossa, and to discuss the clinical value of the virtual intercondylar fossa.
[method]
1, in 15 male and 15 female healthy subjects, two knee joints were scanned by MR to obtain two-dimensional images. The MR two-dimensional images were introduced into the Mimics software for three-dimensional reconstruction of the intercondylar fossa of the femur. The width of the intercondylar fossa (ICW), the width of the condyle (ECW), the intercondylar fossa height (ICH), the width of the intercondylar nests were measured. The width of the external condyle (LCW), the width of the medial condyle of the femur (MCW), the intercondylar notch width index (NWI) and the intercondylar notch morphology index (NSI) were calculated (BLL).
2, virtual intercondylar fossa plasty was performed by using Mimics software to digitize the femoral intercondylar fossa.
3, the anatomical relationship between the intercondylar fossa and the cruciate ligament after intercondylar fossa plasty was evaluated by intraoperative and postoperative evaluation.
4, the SPSS17.0 statistics software was used to analyze the digital model of the intercondylar fossa of the femur of men and women. The data were compared by independent sample t test. The data of the digital model of the intercondylar intercondylar fossa were compared with the paired sample t test, and alpha =0.05 was used as the test standard.
[results]
1, the ICW, ECW, ICH, BLL, LCW and MCW of femur intercondylar fossa of male and female have significant difference (P0.05), NWI and NSI have no significant difference (P0.05).
2, there were no significant differences in ICW, ECW, ICH, BLL, LCW, MCW, NWI and NSI between male and female femur intercondylar fossa models (P0.05).
3, during the reconstruction of ACL, the virtual resection of the bone volume was used for the reconstruction of the intercondylar fossa. The reconstruction of the ligament was just close to the top and lateral wall of the intercondylar fossa in the hyperextension of the knee. The reconstruction of the cruciate ligament and the intercondylar fossa had no impact on the reconstruction of the knee joint in March.
[Conclusion]
There is significant difference in the anatomical morphology of the intercondylar fossa between male and female. There is no difference between NWI and NSI, and there is no significant difference in the measurement indexes of the intercondylar fossa of the left and right femur. The intercondylar nest index is one of the indexes reflecting the stenosis degree of the intercondylar fossa, which is helpful to guide the intercondylar fossa plasty, and the virtual intercondylar fossa formation is feasible and it can be a anterior cruciate ligament. Reconstruction of intercondylar fossa formation provides preoperative reference and has certain clinical guiding significance.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R322.7

【参考文献】