CT三维重建分析不同体位下股骨侧弓对下肢力线测量的影响

发布时间：2018-04-02 13:34

本文选题：组织工程　切入点：股骨　出处：《中国组织工程研究》2017年11期

【摘要】：背景:下肢力线的测量结果经常受到多种因素的影响而出现偏差,不同体位下股骨侧弓角可影响下肢力线的测量。目的:通过CT扫描数据重建下肢骨骼模型,模拟下肢全长X射线检查,测量该模型在不同的旋转角度下的股骨侧弓角及股骨外翻角等数值,并探讨股骨侧弓对下肢力线测量的影响规律。方法:纳入进行下肢动脉CT血管造影的患者20例,Mimics 13.0软件对各病例CT扫描数据重建出该肢体骨骼的三维立体模型,确认其标准正位股骨侧弓角,分为4组:股骨侧弓角2°组,股骨侧弓角大于0°,2°组,股骨侧弓角-2°小于0°组,股骨侧弓角-2°组,每组5例。利用软件功能使其沿下肢纵轴以2°步幅精确旋转出自内旋20°至外旋20°的21个图像,由所得图像测量不同体位下的股骨侧弓角及股骨外翻角,以模拟下肢全长X射线检查下肢伴有旋转的情况。结果与结论:(1)股骨侧弓角的变化规律显示,下肢内旋使股骨侧弓角呈减小趋势,下肢外旋使股骨侧弓角加大趋势;(2)股骨外翻角随肢体外旋有逐渐增大的趋势,而随肢体内旋有逐渐减小的趋势;(3)各组不同体位下的股骨侧弓与股骨外翻角均呈显著正相关(P0.01);(4)结果显示:采用CT扫描数据重建下肢骨骼模型模拟下肢全长X射线检查可见,股骨侧弓角测量结果会随肢体旋转发生变化,且会对股骨外翻角的测量结果产生影响,侧弓程度越大,由此产生的影响越大,所以拍摄下肢正位全长X射线片时应采用标准正位为投照体位,尤其对于股骨侧弓较大的病例。
[Abstract]:Background: the measurement results of force line of lower extremity are often influenced by many factors, and the angle of lateral arch of femur can influence the measurement of force line of lower extremity under different posture. Objective: to reconstruct lower limb bone model by CT scan data. The full-length X-ray examination of the lower extremity was simulated to measure the angle of the femoral side and the valgus angle of the femur at different rotation angles. Methods: twenty patients with lower extremity arterial CT angiography were included in this study to reconstruct the three-dimensional model of limb bone by using the CT scanning data of 20 patients with lower extremity arterial CT angiography by using Mimics 13.0 software, and to investigate the effect of lateral femoral arch on the measurement of force line of lower extremity. To confirm the standard right position of the angle of the femur, and to divide it into 4 groups: the group of 2 掳of the angle of the lateral femoral arch, the group of the angle of the lateral arch of the femur greater than 0 掳, the group of the angle of the lateral arch of the femur less than 0 掳, the group of the angle of the lateral arch of the femur 2 掳. In each group of 5 cases, 21 images from internal rotation 20 掳to external rotation 20 掳were accurately rotated along the longitudinal axis of lower extremity by software function. The femoral side bow angle and femoral valgus angle were measured under different body positions. Results and conclusion the changes of the angle of the femur side show that the lower extremity internal rotation makes the angle of the femur arch decrease. The external rotation of the lower extremity makes the angle of the lateral arch of the femur increase. (2) the angle of the femoral varus increases gradually with the external rotation of the limb. The results showed that there was a significant positive correlation between femoral lateral arch and femoral valgus angle in each group. The results showed that the CT scan data were used to reconstruct the lower limb bone model to simulate the lower limb full-length X-ray examination. The measurement results of femoral lateral arch angle will change with the rotation of the limbs, and will have an effect on the measurement results of the femoral valgus angle. The greater the degree of the lateral arch, the greater the impact. Therefore, the standard orthostatic position should be used when taking the full-length X-ray film of the lower extremity, especially in the case of larger lateral arch of femur.
【作者单位】：北京协和医学院研究生院;中日友好医院骨关节外科;中日友好医院放射诊断科;
【基金】：首都卫生发展科研专项项目(2016-2-4062)~~
【分类号】：R687

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