CT重建人上胫腓骨关节面坡度测量方法及意义

背景：测量上胫腓关节坡度不仅可研究国人上胫腓关节解剖结构与类型,还具有评价上胫腓关节稳定性的作用。 目的：通过测量双侧上胫腓关节面X射线平片坡度与利用64排螺旋CT重建后的关节面坡度进行比较,探讨测量方法的优良及关节坡度的临床意义。 方法：选取正常成年男女各50名志愿者,年龄18~90岁,分别行双膝关节内旋30°或45°或60°摄片及64排螺旋CT扫描并重建胫腓骨全长(包括膝关节)。选用角尺测量上胫腓关节面与腓骨干纵轴的夹角和上胫腓骨关节面与水平线的夹角。 结果与结论：X射线及螺旋CT对同一上胫腓骨关节测量数据差别较大。由于X线受摄片位置影响,且关节面倾斜度的确定比较粗略,因此64排螺旋CT重建后的测量方法准确,方便,对于鉴别上胫腓骨关节脱位和关节不稳提供帮助,减少临床误诊。

Method and significance of measuring the slope of proximal tibiofibular joint with CT reconstruction

BACKGROUND: Measuring the slope of proximal tibiofibular joint may elucidate the anatomical structure and type of proximal tibiofibular joint, and evaluate the stability of proximal tibiofibular joint. OBJECTIVE:To investigate the measurement methods and clinical significance of the joint slope by comparing the slope measurement of bilateral proximal tibiofibular joint surface on X-ray and 64-row spiral CT reconstruction. METHODS:One hundred normal adult volunteers, including 50 males and 50 females, aged 18-90 years, were photographed in double knees via internal rotation to 30°, 45° and 60°, respectively and scanned with 64-row spiral CT, tibiofibular bone (including knee joints) was reconstructed. The included angle between proximal tibiofibular articular surface and the longitudinal axis of the fibula shaft, between the proximal tibiofibular articular surface and the horizontal line, were measured using an angle square. RESULTS AND CONCLUSION:There were great variations of the data in the same proximal tibiofibular joint measured by X-ray and spiral CT. X-ray results are affected by the site of photograph position, and the slope of articular surface is estimated, so the 64-row spiral CT is an accurate and convenient method to reconstitute the slope of proximal tibiofibular joints. Spiral CT could be used to distinguish the dislocation and instability of the proximal tibiofibular joint, accordingly reduce the clinical misdiagnosis.