股骨髁间窝影像和解剖学研究及其临床意义
发布时间：2018-07-14 07:50
【摘要】：目的:通过测量人体股骨骨骼标本髁间窝分析CT及X线与直接测量的差异;CT及X线测量经关节镜证实存在ACL慢性损伤患者的术前髁间窝指标,探讨两种方法预测髁间窝狭窄的可靠性及其临床意义。方法:1.选取延边大学解剖教研室提供的成人股骨完整标本69具。分别对标本股骨髁间窝进行直接测量,X线与CT拍摄后获得的图像上测量,获得股骨髁间窝宽度(ICW)、髁间窝宽度指数(NWI)、股骨髁间窝宽度(髁间窝关节面边缘)、股骨髁间窝宽度(髁间窝上2/3高度)、股骨髁宽度、髁间窝角,同时通过三种方法对髁间窝进行分型,比较CT及X线与直接测量的差异。2.选取延边大学附属医院骨关节及运动医学外科自2016年3月至2016年12月期间收治的单侧在关节镜下证实存在因髁间窝狭窄导致ACL慢性损伤者共90例。所有患者术前均拍摄CT及X线,在获得的图像上测量并计算髁间窝宽度(ICW)及髁间窝宽度指数(NWI),各组间的测量值与骨骼标本的标准值进行比较,同时对髁间窝分型并按性别差异进行对比。结果:1.骨骼标本测量中,直接测量和CT测量所有结果均无差异(P0.05),直接测量和X线测量结果除髁间窝宽度指数(NWI)外所有指标均有显著差异(P0.05),三种方法的髁间窝分型完全一致。2.临床病例测量中,CT:髁间窝宽度(ICW)为16.68±1.03mm,显著低于标准值18.51mm(P0.05);髁间窝宽度指数(NWI)0.22±0.02,也显著低于标准值0.24(P0.05)。X线:髁间窝宽度(ICW)为16.87±.05mm,显著低于标准值19.18mm(P0.05);髁间窝宽度指数(NWI)0.22±0.02,显著低于标准值0.24(P0.05)。根据NW I标准值和测量值,CT确定77例(86%)存在髁间窝狭窄;X线确定68例(76%)存在髁间窝狭窄。CT与关节镜髁间窝分型一致,X线与前两者略有差异。男女患者髁间窝分型有显著差异,女性A型及W型髁间窝比例大于男性,男性U型髁间窝比例大于女性。结论:CT是测量股骨髁间窝及预测髁间窝狭窄比较可靠的影像学方法,X线虽然不如CT准确、立体,但仍具有一定的参考价值。影像学测量股骨髁间窝NWI及观察髁间窝形态对预测ACL损伤风险具有重要的临床意义。
[Abstract]:Objective: by measuring the differences of CT and X-ray and direct measurement in the intercondylar fossa of human femur bone specimens, CT and X-ray measurements confirmed the preoperative intercondylar fossa indexes of patients with ACL chronic injury by arthroscopy, and discussed the reliability and clinical significance of two methods for predicting the stenosis of intercondylar fossa. Methods: 1. select the anatomy teaching and Research Department of Yanbian University. 69 complete femoral femoral specimens. The intercondylar fossa of the femur was measured directly. The width of the intercondylar fossa (ICW), the width index of the intercondylar fossa (NWI), the width of the intercondylar fossa (intercondylar fossa's surface edge), the width of the femoral intercondylar fossa (the 2/3 height on the intercondylar fossa), the width of the femoral condyle, the intercondylar intercondylar, and the width of the condyle fossa of the femur were measured by X-ray and CT images. At the same time, three methods were used to classify the intercondylar fossa, and the differences of CT and X-ray and direct measurement were compared..2. selected from March 2016 to December 2016 of the Affiliated Hospital of Yanbian University confirmed that there were 90 cases of chronic ACL injury caused by the narrowing of the intercondylar fossa. CT and X ray were taken before the operation. The width of the intercondylar fossa (ICW) and the intercondylar fossa width index (NWI) were measured and calculated on the obtained images. The measured values between each group were compared with the standard values of the bone specimens. At the same time, the intercondylar fossa was divided and the sex differences were compared. Results: 1. bone specimens were measured, and all the results were measured by direct and CT measurements. The difference (P0.05), the results of the direct and X-ray measurements were significantly different (P0.05) except the intercondylar width index (NWI). The intercondylar fossa width (ICW) of the three methods was 16.68 + 1.03mm, significantly lower than the standard 18.51mm (P0.05), and the intercondylar fossa width index (NWI) was 0.22 + 0.02 in the.2. clinical case measurement. Significantly lower than standard value 0.24 (P0.05). X: the width of the intercondylar fossa (ICW) was 16.87 +.05mm, significantly lower than the standard value 19.18mm (P0.05); the intercondylar fossa width index (NWI) was 0.22 + 0.02, significantly lower than the standard value 0.24 (P0.05). According to NW I standard value and measured value, CT confirmed 77 cases (86%) had intercondylar fossa stenosis; X-ray confirmed 68 cases (76%) had intercondylar fossa stenosis.CT and The intercondylar fossa of arthroscopy was the same. There was a slight difference between the X - ray and the former two. There were significant differences in the intercondylar fossa of male and female patients. The proportion of female A type and W type intercondylar fossa was greater than that of men, and the proportion of male U intercondylar fossa was greater than that of women. Conclusion: CT is a reliable imaging method for measuring the intercondylar fossa of the femur and predicting the stenosis of intercondylar fossa, although the X ray is not as accurate as CT, Stereoscopic, but still of certain reference value, imaging measurement of NWI and observing the shape of intercondylar fossa in femoral intercondylar fossa is of great clinical significance in predicting the risk of ACL injury.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687;R322
本文编号：2120963
[Abstract]:Objective: by measuring the differences of CT and X-ray and direct measurement in the intercondylar fossa of human femur bone specimens, CT and X-ray measurements confirmed the preoperative intercondylar fossa indexes of patients with ACL chronic injury by arthroscopy, and discussed the reliability and clinical significance of two methods for predicting the stenosis of intercondylar fossa. Methods: 1. select the anatomy teaching and Research Department of Yanbian University. 69 complete femoral femoral specimens. The intercondylar fossa of the femur was measured directly. The width of the intercondylar fossa (ICW), the width index of the intercondylar fossa (NWI), the width of the intercondylar fossa (intercondylar fossa's surface edge), the width of the femoral intercondylar fossa (the 2/3 height on the intercondylar fossa), the width of the femoral condyle, the intercondylar intercondylar, and the width of the condyle fossa of the femur were measured by X-ray and CT images. At the same time, three methods were used to classify the intercondylar fossa, and the differences of CT and X-ray and direct measurement were compared..2. selected from March 2016 to December 2016 of the Affiliated Hospital of Yanbian University confirmed that there were 90 cases of chronic ACL injury caused by the narrowing of the intercondylar fossa. CT and X ray were taken before the operation. The width of the intercondylar fossa (ICW) and the intercondylar fossa width index (NWI) were measured and calculated on the obtained images. The measured values between each group were compared with the standard values of the bone specimens. At the same time, the intercondylar fossa was divided and the sex differences were compared. Results: 1. bone specimens were measured, and all the results were measured by direct and CT measurements. The difference (P0.05), the results of the direct and X-ray measurements were significantly different (P0.05) except the intercondylar width index (NWI). The intercondylar fossa width (ICW) of the three methods was 16.68 + 1.03mm, significantly lower than the standard 18.51mm (P0.05), and the intercondylar fossa width index (NWI) was 0.22 + 0.02 in the.2. clinical case measurement. Significantly lower than standard value 0.24 (P0.05). X: the width of the intercondylar fossa (ICW) was 16.87 +.05mm, significantly lower than the standard value 19.18mm (P0.05); the intercondylar fossa width index (NWI) was 0.22 + 0.02, significantly lower than the standard value 0.24 (P0.05). According to NW I standard value and measured value, CT confirmed 77 cases (86%) had intercondylar fossa stenosis; X-ray confirmed 68 cases (76%) had intercondylar fossa stenosis.CT and The intercondylar fossa of arthroscopy was the same. There was a slight difference between the X - ray and the former two. There were significant differences in the intercondylar fossa of male and female patients. The proportion of female A type and W type intercondylar fossa was greater than that of men, and the proportion of male U intercondylar fossa was greater than that of women. Conclusion: CT is a reliable imaging method for measuring the intercondylar fossa of the femur and predicting the stenosis of intercondylar fossa, although the X ray is not as accurate as CT, Stereoscopic, but still of certain reference value, imaging measurement of NWI and observing the shape of intercondylar fossa in femoral intercondylar fossa is of great clinical significance in predicting the risk of ACL injury.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687;R322
【参考文献】
相关期刊论文 前9条
1 齐萌;王颖;叶颖;吴文灏;;健康成年人膝关节髁间窝宽度与高度的MRI研究及临床意义[J];中国中西医结合影像学杂志;2013年02期
2 Martin Schencking;Stefan Wilm;Marcus Redaelli;;A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis: a pilot trial[J];Journal of Integrative Medicine;2013年01期
3 李彦林;许鹏;韩睿;王建伟;何川;王国梁;仝路;胡猛;;基于MRI二维影像下股骨髁间窝的三维可视化研究[J];中国修复重建外科杂志;2012年10期
4 许鹏;李彦林;陈文栋;杨光;王国梁;仝路;胡猛;;MRI影像下股骨髁间窝三维数字化解剖学数据与实体解剖测量值的差异[J];中国组织工程研究与临床康复;2011年43期
5 马勇;敖英芳;;前交叉韧带断裂后股骨髁间窝变化的影像学研究[J];中华关节外科杂志(电子版);2009年02期
6 许维亚;金涛;向选平;茹能;杜远立;;股骨髁间窝宽度CT测量的方法及意义[J];生物骨科材料与临床研究;2008年05期
7 刘浩江,刘安庆,张世权,鄢宏,陈慕芬;股骨髁间窝狭窄的临床研究[J];中国骨与关节损伤杂志;2005年05期
8 张志强,卫小春,任步芳;股骨髁间窝宽度的放射学测量[J];中华放射学杂志;2003年12期
9 薛庆云,黄公怡;股骨髁间前交叉韧带撞击症[J];中华骨科杂志;1998年01期
，本文编号：2120963
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2120963.html
最近更新
教材专著
