学龄期儿童寰枢椎数字化三维形态测量研究

发布时间：2018-03-20 15:01

本文选题：寰枢椎　切入点：数字化测量　出处：《中国脊柱脊髓杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:通过CT三维影像观测学龄期儿童(7~12岁)寰、枢椎形态结构,探索学龄期儿童寰、枢椎形态特征和增龄变化规律,为学龄期儿童寰、枢椎疾病的早期诊治和预防提供理论依据。方法:收集内蒙古医科大学附属医院及赤峰市第二医院2013~2014年行颈椎CT扫描的学龄期儿童影像资料,排除寰枢椎骨折、畸形、结核等疾病。将收集到的原始DICOM数据导入Mimics 16.0进行三维重建,运用软件的三维测量工具在重建的三维模型上对其寰、枢椎侧块及椎弓根相关指标进行测量,包括寰椎的侧块横径(LMD)、侧块内倾角(d角)、侧块前后径(LMB)、侧块上倾角(e角)、椎弓根宽度(AW)、椎弓根全长(AL)、椎弓根外偏角(b角)、椎弓根高度(AH)及椎弓根尾偏角(c角);枢椎的椎弓根全长(APL)、椎弓根宽度(APW)、椎弓根外偏角(f角)、椎弓根高度(APH)及椎弓根尾偏角(g角)。将观测对象按年龄每两岁为一组共分三组,即A组(7~8岁)、B组(9~10岁)、C组(11~12岁),并行统计分析。结果:LMD随年龄递增呈递增趋势,A组左侧为13.91±1.95mm,右侧为14.11±1.95mm;B组左侧为14.31±2.24mm,右侧为14.36±2.39mm;C组左侧为17.18±2.32mm,右侧为17.10±2.41mm;LMD左侧C组与A、B组间有统计学差异(P0.05);LMD在各组左、右侧间比较有差异(P0.05)。其他指标也随年龄呈递增趋势,同侧C组与A组比较除f角外均有显著差异(P0.05);同侧C组与B组比较仅AH、APW及APH间存在显著差异(P0.05);同侧A组与B组比较仅AL、AW、APL、APH及g角间存在显著差异(P0.05);同组左、右侧间比较仅LMB和d角间有显著性差异(P0.05)。结论:学龄期儿童寰枢椎椎弓根及侧块形态结构复杂,且发育未完全,对各骨性结构发育规律的三维结构形态进行观测,可为临床及进一步研究其周围毗邻结构提供参考依据。
[Abstract]:Objective: to observe the morphological structure of atlas and axis in school-age children aged 7 ~ 12 years by means of three-dimensional CT imaging, and to explore the morphological characteristics and aging change of atlas and axis in school-age children. Methods: the imaging data of school-age children who underwent cervical CT scanning from 2013 to 2014 were collected in the affiliated Hospital of Inner Mongolia Medical University and the second Hospital of Chifeng City to exclude atlantoaxial fractures and deformities. Tuberculosis and other diseases. The collected original DICOM data were imported into Mimics 16.0 for 3D reconstruction. The atlantoaxial lateral mass and pedicle were measured on the reconstructed 3D model with the software 3D measurement tool. These include lateral mass transverse diameter of atlas (LMDA), lateral mass inclination angle (LMD), lateral mass anterior and posterior diameters (LMBM), lateral mass upper inclination angle (AMB), pedicle width (AW), pedicle length (ALD), lateral pedicle angle (AH), pedicle height (AH) and pedicle tail angle (C angle). The total length of pedicle of vertebrae, the width of pedicle, the angle of external angle of pedicle, the height of pedicle and the angle of pedicle tail were divided into three groups according to the age of two years. The results of statistical analysis showed that the left side of group A is 13.91 卤1.95 mm, the right is 14.11 卤1.95 mm of group B, the left side of group C is 17.18 卤2.32 mm of right side, and the right side is 17.18 卤2.32 mm of right side, and 17.10 卤2.41 mm of left side of group A, and 17.10 卤2.41 mm of LMD of right side. There was a significant difference in P0.05LMD in the left of each group. There was a difference between the right side and the other indexes, and the other indexes showed an increasing trend with age. There were significant differences between ipsilateral group C and group A except for f angle (P0.05), between ipsilateral group C and group B only between APH and AH-APW, between ipsilateral group A and group B, between group A and group B, between group A and group B, and between group A and group B, respectively (P 0.05), and between group A and group B, there were significant differences in APH and g angle between group A and group B, while in group A, there was significant difference between group A and group B (P 0.05). There was only significant difference between LMB and d angle in the right side. Conclusion: the morphology and structure of atlantoaxial pedicle and lateral mass in school-age children are complex and incomplete. It can provide reference for clinical and further study of adjacent structures.
【作者单位】：内蒙古赤峰市第二医院骨外一科;内蒙古医科大学解剖学教研室;内蒙古医科大学数字医学中心;
【分类号】：R322.7;;TP391.7

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