TT-TG测量方法及与其它髌骨稳定参数相关性的研究

发布时间：2018-04-26 01:36

本文选题：髌骨稳定 + 胫骨结节-股骨滑车沟距离　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:利用CT图像叠加融合技术对膝关节CT图像进行分析,测量设定的股骨滑车不同参考层面的胫骨结节-股骨滑车沟距离(TT-TG),分析选取股骨滑车沟不同位置为基点对TT-TG测量的影响。并评价在每个参考层面以股骨滑车沟最深点及股骨髁间窝最深点作为股骨端垂线的两种测量方法获得TT-TG及胫骨结节-股骨髁间窝距离(TT-PD)。测量不同参考层面的股骨滑车沟角角度,髌韧带长度与髌骨长度的比值(PLL/PL)以及髌内、外侧支持带长度,探讨这些参数与TT-TG值之间的相关性。对象与方法:本研究分为两部分,第一部分为TT-TG测量方法的探讨,纳入在我院行膝关节CT检查的患者共60例,其中男42例,女18例,左侧膝关节31例,右侧膝关节29例,年龄18至40岁,将CT扫描获得的薄层图像数据传入工作站进行后处理重组及测量。将设定的股骨滑车沟5个等分参考层面与所选定的胫骨结节层面图像叠加,测量TT-TG值并进行方差分析,并在这5个叠加图像上测量TT-PD值并进行方差分析;分别分析5个参考层面测量的TT-TG值与TT-PD值的相关性;比较左、右侧膝关节TT-TG值的差异以及男、女性膝关节TT-TG值的差异。第二部分为TT-TG与其它髌骨稳定参数的相关性研究,对上述纳入的病例,在5个等分参考层面上测量滑车沟角角度,在重组正中矢状位图像上测量髌骨长度、髌韧带长度并依据Insall-Salvati比率法计算其比值,在选定的轴位图像上测量髌内、外侧支持带长度。分析在5个参考层面测得5组股骨滑车沟角角度间的差异;分别对滑车沟角角度、髌韧带长度与髌骨长度的比值、髌内、外侧支持带长度与测量的TT-TG距离进行相关性分析。结果:选取股骨滑车沟不同位置为基点所测得的TT-TG值差异无统计学意义(P0.05),相应层面所测得的TT-PD值差异无统计学意义(P0.05);但比较这两种方法测量的TT-TG值与TT-PD值差异有统计学意义(P0.05),TT-PD数值偏大,且TT-TG值与TT-PD值两组数据间呈明显正性相关关系。左、右两侧膝关节的TT-TG值差异无统计学意义(P0.05)。男、女不同性别的膝关节TT-TG值差异无统计学意义(P0.05)。选择股骨滑车面不同位置作为参考层面,所测得的股骨滑车沟角差异有统计学意义(P0.05)。股骨滑车沟角,髌韧带长度与髌骨长度的比值,髌内、外侧支持带长度均与TT-TG值之间没有相关性。结论:在股骨滑车沟任意一点测量TT-TG值均可作为评价参数。两种不同方法测得的两种距离TT-TG和TT-PD数值有差异,以后者股骨髁间窝最深点选取股骨端垂线的测量方法数值偏大。在进行左、右侧别及男、女性别的TT-TG值比较时,发现左侧膝关节TT-TG值要低于右侧,男性膝关节TT-TG值均比女性偏大。TT-TG值能够反映髌骨的稳定性,股骨滑车沟角,髌韧带长度与髌骨长度的比值,髌内、外侧支持带长度均与TT-TG值未见明显相关性,但是滑车沟角,髌韧带长度与髌骨长度的比值是髌骨稳定的重要因素,髌内、外侧支持带为固定髌骨的因素,所以评价髌骨稳定性时需要多参数测量。
[Abstract]:Objective: to analyze the CT image of the knee joint by CT image superposition fusion technique, to measure the tibial tubercle of the different reference layers of the trochlea of the femur and the distance of the trochlear trench (TT-TG), and to analyze the influence of the different position of the trochlear trench of the femur on the measurement of the TT-TG, and to evaluate the deepest point and the femoral trochlear trench at the reference level. TT-TG and tibial tubercle intercondylar fossa distance (TT-PD) were obtained by two methods of measuring the deepest point of the intercondylar fossa. The angle of the trochlear groove angle, the ratio of the length of the patellar ligament to the patellar length (PLL/PL) and the length of the patellar and lateral retinaculum were measured at different reference levels, and the correlation between these parameters and the value of the TT-TG was discussed. The study was divided into two parts. The first part was divided into two parts. The first part was the study of the method of TT-TG measurement. There were 60 cases of knee joint CT examination in our hospital. There were 42 men, 18 women, 31 left knee joints, 29 right knee joints, 18 to 40 years old, and the CT scan obtained thin layer image data to the workstation for post-processing and reprocessing. And measurements. The TT-TG values of the 5 equal sections of the trochlea trench and the selected tibial tubercle image were superimposed, and the values were measured and the variance analysis was carried out. The TT-PD values were measured on the 5 superimposed images and the variance analysis was carried out. The correlation between the TT-TG value of the 5 reference layers and the TT-PD value were analyzed, and the left and right knee joints were compared. The difference in TT-TG values and the difference in the TT-TG value of the knee joint in men and women. The second part is the correlation between TT-TG and other patellar stability parameters. The above included cases are measured at the angle of the trochlear angle at the 5 level of reference level and the patellar length is measured on the reconstructed median sagittal image, the length of the patellar ligament is based on the Insall-Salvati ratio. The ratio was calculated by the rate method. The length of the medial patellar and lateral support band was measured on the selected axial image. The differences between the angle of the 5 groups of trochlear trench angles were measured at 5 reference levels, and the ratio of the angle of the trochlear angle, the length of patellar ligament to the length of the patella, the length of the lateral patellar support band and the distance of the measured TT-TG were analyzed. Results: there was no statistically significant difference in the TT-TG value measured in the different position of the trochlear trench of the trochlear groove (P0.05). There was no significant difference in the TT-PD value measured at the corresponding level (P0.05), but the difference between the TT-TG value measured by the two methods and the TT-PD value was statistically significant (P0.05), the TT-PD value was larger, and the TT-TG value and the TT-PD value were two groups. There was no significant difference in TT-TG value between the left and right sides of the knee (P0.05). There was no statistically significant difference in the TT-TG value of the knee joint in male and female sex (P0.05). The difference of the different position of the trochlear surface of the femur was statistically significant (P0.05). The femoral trochlear groove was statistically significant (P0.05). Angle, the ratio of the length of patellar ligament to the length of the patella, there is no correlation between the length of the medial patellar and the lateral support band and the TT-TG value. Conclusion: the measurement of the TT-TG value at any point in the trochlear groove of the femur can be used as an evaluation parameter. The values of the two distances measured by the two different methods are different from the values of TT-TG and TT-PD, and the femur is selected at the deepest point in the intercondylar fossa of the femur. The TT-TG value of the left knee joint was lower than that of the right, and the TT-TG value of the male knee joint was higher than that of the female, and the TT-TG value of the male knee joint was better than the female.TT-TG value to reflect the stability of the patella, the angle of the trochlear trench, the ratio of the patellar ligament length to the patellar length, the internal and lateral branches of the patellar tendon, and the ratio of the patellar length to the patellar length. There is no significant correlation between the length of the holding band and the TT-TG value, but the ratio of the length of patellar ligament to the length of patellar ligament is an important factor for patellar stability. In the patellar, the lateral support band is the factor of patellar fixation, so it is necessary to measure the stability of the patella when evaluating the patellar stability.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R684;R816.8

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