腰椎椎板形态学测量

发布时间：2018-04-03 23:24

本文选题：腰椎椎板　切入点：形态学　出处：《重庆医科大学》2013年硕士论文

【摘要】：目的通过对无明显脊柱症状成人的腰椎椎板计算机断层扫描（CT）图像进行多平面及三维立体重建，并对L1-L5椎板的各项相关形态学参数进行测量并进行数据分析，从而进一步完善腰椎椎板解剖形态学的定量研究。然后选取性别间无差异的部分参数进行实体腰椎椎板的测量，所得出的各项参数的实际测量数值与CT所测数值进行比较，以验证实际数据与CT测量数据是否存在统计学差异。本实验内容包括以下两个部分：第一部分：无明显脊柱相关症状成人腰椎椎板形态学参数的CT定量测量。第二部分：实体干燥脊柱标本腰椎椎板形态学参数的实际测量，并与CT测量值的统计学比较。方法 1.无明显脊柱相关症状成人腰椎椎板形态学参数的CT定量测量。选取100例无明显脊柱症状成年人的腰椎CT图像，按性别分为两组，每组各50例。调取被测量者的腰椎CT图像，用GE公司的64排CT系统对腰椎图形进行多平面重建，把相关图像导入比利时Materialise公司设计的Mimics10.0软件，用软件相关工具对被测量者的腰椎CT多平面断层图像进行三维重建，并在多平面断层图像及三维重建图像上对腰椎椎板（L1-L5）相关形态学参数进行测量。测量数据主要包括：1.椎板宽度；2.椎板厚度；3.椎板夹角；4.椎管矢状（前后）径；5.椎管横径；6.棘突长度；7.椎板倾斜角；8.棘突高度；9.棘突倾斜角；10.椎板高度。得出的数据用统计学软件SAS8.0进行重复测量设计的方差分析，，以P0.05为具有统计学意义。 2.对实体干燥脊柱标本腰椎椎板形态学参数的进行实际测量，并将实际测量值与CT测量值进行统计学比较。选取20具干燥脊柱腰椎标本，用游标卡尺（日本藤原工业级数显卡尺）及数显角度尺（开拓工具（国际）集团）分别选取部分无性别差异的腰椎椎板相关形态学参数进行测量并记录数据。然后将实体标本进行CT多平面重建及三维重建，用同实验第一部分的方法进行相关参数的测定，得出的CT测量值与实际测量值用统计学软件SPA8.0进行统计学分析，从而得出可靠性分析结果。 1.无明显脊柱相关症状成人腰椎椎板形态学参数的CT定量测量。通过对本实验椎板相关形态学参数测量数据的分析，发现对于腰椎椎板夹角、椎管矢状径、椎板倾斜角、棘突倾斜角同一腰椎节段之间无明显性别差异，但同一性别中不同腰椎节段之间存在显著性差异（P0.05），椎板夹角和椎管矢状径均表现为以L3最小，椎板倾斜角表现为以L3为最大，而棘突倾斜角则表现为L1最大，L5最小。椎板宽度同一性别不同腰椎节段比较呈现以L1-L5递增趋势，且同一腰椎节段性别间比较有显著差异，统一表现为男性女性。总体上看，对于椎板厚度、椎板横径、棘突高度在同一性别不同腰椎节段间存在显著性差异，表现出以L1-L5递减的趋势，而这些参数在同一腰椎节段有显著性别差异，除了椎管横径显示出女性男性外，其余参数均显示为男性女性。对于椎体高度来说同一性别中不同腰椎节段椎板高度有显著性差异，但在男性和女性都存在L1与L2之间相比无显著性差异的结果。不同性别，相同节段腰椎椎板高度比较除了L2之间存在显著性差异外，其余节段腰椎椎板高度无显著性差异，男性和女性中均以L3椎板高度为最高（男性平均值为22.92mm，女性平均值为22.70mm）。 2.腰椎椎板形态学参数实体测量数值与CT测量数值之间比较。选取实验第一部分性别之间无差异的部分参数进行实体与CT数值的测量，两组之间信度相关系数（Cronbach α系数）均0.8，显示出CT测量数值与实体实际测量数值具有较高的一致性。结论 1.通过对椎板相关形态学参数进行研究，进一步完善了椎板形态学解剖的相关数据，为人工椎板的设计提供了更加完善的解剖学基础，也可使人工椎板设计更具性别化、个体化。 2.通过对实体干燥脊柱标本腰椎椎板形态学参数测量值与CT多平面及三维重建层面测量结果进行统计学分析后显示CT测量值有较高的真实可靠性。 3.测量数据有较高的准确性，可通过各参数测量数据进行新型人工腰椎椎板的初步构建。
[Abstract]:objective
The obvious symptoms of adult spinal lumbar laminae of computed tomography (CT) images of multiplanar and three-dimensional reconstruction, and the related morphological parameters of L1-L5 lamina were measured and the data were analyzed, and further improve the lumbar vertebral anatomy. Quantitative study on morphological measurement and then select parameters have no differences between the sexes are the actual measurement of the lumbar vertebral entity, numerical simulation and the parameters of CT derived from the measured values are compared to verify the actual measurement data and CT data is statistically significant.
The contents of this experiment include the following two parts:
Part one: quantitative CT measurement of the morphological parameters of the lumbar vertebral lamina without obvious spinal related symptoms in adults.
The second part: the actual measurement of the morphological parameters of the lumbar vertebral lamina of solid dry spine specimens and compared with the measured values of CT.
Method
The quantitative measurement of CT 1. had no obvious symptoms of adult lumbar spinal lamina morphological parameters. Selected lumbar CT images of 100 patients with no obvious symptoms of adult spine, divided into two groups by gender, 50 cases in each group. The lumbar CT image retrieval measure, multiplanar reconstruction of lumbar geometry with 64 row CT system of GE company the design of the image into the Belgian Materialise company Mimics10.0 software, using software tools to measure the lumbar CT multiplanar images were 3D reconstruction, and multiplanar images and three-dimensional reconstruction images of lumbar lamina (L1-L5) of the related parameters were measured. The measurement data mainly includes: 1. lamina width 2.; lamina thickness; 3. lamina angle; 4. vertebral canal sagittal diameter (before and after) 5.; spinal canal diameter; 6. spine length; 7. lamina angle; 8. spinous process; 9. spinous process vertebral angle; 10. The height of the board. The data obtained by the statistical software SAS8.0 were used for the analysis of the variance of the repeated measurement design, with the statistical significance of P0.05.
The actual measurement of the 2. entity dry spine specimens of lumbar laminae of morphological parameters, and the measured values were compared with the value of CT. Select 20 dry lumbar specimens, using vernier caliper (Japan Fujiwara industrial series caliper) and digital display protractor (open extension tools (International) group) were selected for lumbar lamina some related morphological parameters no gender differences were measured and recorded data. Then the real samples were CT multiplanar reconstruction and three-dimensional reconstruction, determination of related parameters using the same method in the first part of the CT, the measured values were statistically analyzed using statistical software SPA8.0 and the actual measured value, so that the reliability of the analysis results.
1. CT quantitative measurement of the morphological parameters of the lumbar vertebral lamina of adults without obvious spinal related symptoms.
Based on the analysis of the experimental data to measure the morphological parameters related to laminectomy, found for lumbar vertebral angle, sagittal diameter of spinal canal, posterior tilt, tilt angle between the spinous process of lumbar segment with no significant gender differences, but there are significant differences between the same gender in different lumbar segment (P0.05), and the lamina angle sagittal diameter of spinal canal were performed with L3 minimum, laminar slope angle performance of the L3 is the largest, while the spinous process tilt angle showed the maximum L1, L5 minimum. The width of the same gender different posterior lumbar segment is presented in L1-L5 increasing trend, and the same lumbar segment between the sexes is significant difference unified performance for men and women. On the whole, the lamina lamina thickness, transverse diameter, there is a significant difference between the spinous process of different height in the same sex lumbar, to L1-L5 showed a decreasing trend, and these parameters are significant in the same segment The gender difference, in addition to spinal canal diameter showed a female male, the rest of the parameters are shown as men and women. For the same gender vertebral height in different lumbar segment vertebral height has significant differences, but in both men and women between L1 and L2 showed no significant difference. The results of different gender. The same segment of lumbar vertebral height in addition to significant differences between L2 and other segments of the lumbar vertebral height had no significant difference between male and female L3 are the highest laminar height (male average was 22.92mm, the average woman value is 22.70mm).
The comparison between the 2. lumbar lamina morphological parameters and CT measurement entity numerical value. The difference between the measurement of selected parameters of the first part of the experiment, sex numerical entities and CT, the correlation coefficient between the two groups of reliability (Cronbach coefficient) were 0.8, showing consistency with the actual measured value entity has a high CT value measurement.
conclusion
1., through studying the related morphological parameters of laminae, we further improve the related data of lamina morphology and anatomy, provide a better anatomical basis for the design of artificial lamina, and make the design of artificial lamina more gender and individuation.
2., through statistical analysis of the measured values of lumbar vertebral lamina morphology parameters and CT multiplanar and three-dimensional reconstruction levels, we can see that CT measurement has high reliability.
3. the measured data have high accuracy, and the preliminary construction of a new type of artificial lumbar vertebral lamina can be carried out through the measurement of data.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8

【参考文献】