中国人肱骨的年龄鉴定

目的 对肱骨上端骨松质长度和骨松质指数进行年龄鉴定。方法 随机拍摄１０－９３岁１７７例（男９０例，女８７例）汉族人上肢双侧肩部前后位Ｘ线片，。每个性别的观察对象分成９个年龄组，分别测量Ｘ线片上有上端骨松质长度，计算肱骨上端骨松质指数。结果肱骨上端骨松质长度与指数随年龄增长逐渐变小，与年龄呈高度负相关。根据肱骨上端骨松质长度和指数与年龄的关系得出回归方程。     

肱骨髁上突的影像学特征分析

目的 探讨肱骨髁上突的影像学特征。方法 回顾性分析2013年7月-2019年4月扬州大学附属医院放射科14例肱骨髁上突患者的影像学资料,男11例、女3例,年龄2～86[33(22,48)]岁, 髁上突位于左侧肱骨8例、右侧肱骨6例。14例患者均行数字化X线摄影(DR),其中6例行多层螺旋CT(MSCT)检查。测量和计算肱骨髁上突的相对长度比(肱骨侧位DR片髁上突长度与髁上突根部肱骨横径比值)、距肱骨内上髁的相对距离比(肱骨髁上突距肱骨髁上的距离绝对值与髁上突根部肱骨横径比值)、体部与肱骨干远端的夹角,观察基底宽或窄、尖端指向以及有无骨髓腔与软骨帽。结果 14例患者变异侧肱骨下段前内侧见骨性棘状物突起,相对长度比为0.44±0.13,距肱骨内上髁相对距离比为1.87±0.28,体部向肘关节倾斜或与肱骨干垂直,体部与肱骨干远端的夹角为63.60°±21.20°。14例肱骨髁上突均为宽基底,前端尖细、指向内上髁,骨性突起的境界清楚,密度略低于或基本等同于骨皮质密度,未见软骨帽及骨髓腔。结论 肱骨髁上突的特征性影像学表现为距肱骨内上髁3～8 cm处肱骨下段前内侧,起源于肱骨骨皮质的鸟嘴状或棘状骨性突起,基底较宽,尖端较细并指向肘关节方向,体部向肘关节倾斜或与肱骨干垂直,无骨髓腔与软骨帽。     

肱骨大结节内骨小梁变化与年龄的关系

目的:观察国人肱骨大结节内骨小梁变化的年龄特征,为应用肱骨大结节内骨小梁的变化进行年龄鉴定提供依据。方法:随机拍摄10~93岁177例汉族人上肢双侧肩部前后位X线片,并对每个性别每个年龄组X线片上肱骨大结节内骨小梁的疏密度、粗细及与骨髓腔的融合情况进行观察。结果:根据观察结果,将肱骨大结节内骨小梁的这些指标的变化分成5期。随着年龄的增长,国人肱骨大结节内骨小梁疏密度、粗细及与骨髓腔融合时间表现出不同的特征。结论:肱骨大结节内骨小梁的变化具有年龄相关性。这为应用其进行年龄鉴定提供了国人的参考依据。     

枕骨基底部骨松质发育不全的影像解剖

目的：明确枕骨基底部低密度影的形成机理及其与舌下神经管的关系。方法：采用４０侧矢状切正常成人颅的横切面标本和８４例在门诊行颅底扫描者的正常ＣＴ片。结果：枕骨基底部骨松质发育不良区及其影像表现以椭圆形为常见。在骨标本上测得骨松质发育不良区长９．５±２．９ｍｍ，宽６．４±３．１ｍｍ，高５．４±１．８ｍｍ。指出了在ＣＴ图像上区分枕骨基底部发育不良影和舌下神经管影的方法。结论：枕骨基底部低密度影系枕骨基底部骨松质局部发育不良所致。     

骨上皮样血管内皮瘤1例

患者,女性,78岁,因左上臂肿胀伴指端麻木4年余在浙江大学附属第一医院就诊。查体：左肩及上臂肿胀明显,皮肤红肿,左上肢活动受限,左手指麻木不适,左手握拳不能。X线：左侧肱骨上中段形态不完整,骨皮质毛糙,骨髓质致密,髓腔内密度增高,与正常段分界尚清,相邻软组织肿胀（图1）。     

成人肱骨骨髓腔的应用解剖

目的　研究成人肱骨骨髓腔的解剖特征 ,为临床应用提供解剖学基础。方祛　 4 0根成人肱骨标本矢状切开 ,观察髓腔形态 ,并测量一些数值。结果　髓腔似漏斗状 ;肱骨髓腔平均长 (2 7 6 4± 1 4 8)cm ;狭窄处位于髓腔中点下 10cm处。结论　行肱骨内固定时 ,应考虑肱骨髓腔长度、狭窄部和髓腔弧度 ,以免造成新的损伤。     

肱骨远端髓腔内骨嵴的形态特点及其临床意义

目的:探讨肱骨远端髓腔内骨性突起形态学特征及其潜在的临床意义。方法:应用16层CT对80根肱骨远段1/3进行扫描,三维重建成像后,从冠状面、矢状面和横截面观察并描述鹰嘴窝上髓腔内骨性突起的形态特点,然后将20根肱骨远段1/3在冠状面上从中线纵行剖开,对髓腔内骨嵴行直观的观察。结果:鹰嘴窝上髓腔内1.9～3.2cm(平均2.6cm)范围内存在骨性突起,骨质与皮质骨相近,基底部位于后方,内、外侧分别呈倒八字形排列,骨嵴以一侧为主,其中59根以内侧为主,21根以外侧为主,呈2～3行平行排列,另一侧骨嵴则较紊乱。结论:本文描述了以前未有记载的肱骨远端髓腔内骨嵴的形态,对肱骨远端骨折内固定和肘关节人工关节置换都有一定的临床意义。     

肱骨髁上突3例

肱骨髁上突３例冯宝龄①王树相①王静①李月萱①例１，男，８岁。无意中发现左肘内上方骨性肿物６月，于１９９３年５月２１日来诊。查体：左上臂下１／３处内前方触及一硬性突起，不活动，局部皮色正常，临床诊断“骨软骨瘤”。Ｘ线检查：左肱骨下段内侧有一长约１．２ｃ...     

狗胫骨骨髓腔内植入胫前动脉的实验解剖学研究

在６只狗的胫骨上，行骨膜剥离，“Ｚ”骨折固定，两端胶封制成截血骨模型。在骨髓腔内植入胫前动脉。术后２、４、８ｗ做Ｘ线造影和动脉铸型的解剖学研究。结果显示，在截血的骨干，植入髓腔内的胫前动脉生长出新的血管，沿髓腔向下生长，担负起截血骨干愈合所须的血供。     

肱骨髓腔的形态学参数测量及临床意义

目的 :为髓内钉的研制提供解剖学依据。方法 :分别以防腐湿肱骨 ,新鲜肱骨和干肱骨为材料 ,用牙托树脂灌铸成型后测量其内径 ;用螺旋CT测量活体肱骨髓腔内径 ,所有数据进行统计处理 ,观察各组数据的相关性关系。结果 :肱骨髓腔在中上 2 /3接近不规则圆柱体 ,自中下 1/3开始在矢状面上有一向前为 (8.8± 0 .3 )°的弧度。在桡神经沟部位的单侧骨密质最厚 (6.0± 1.5 )mm。髓腔最狭窄的部位在肱骨中下 1/3左右 ,其冠状径、矢状径在 7～ 8mm左右。分组统计结果证明 ,防腐湿肱骨的形态与新鲜肱骨无差别 ,干肱骨的形态与其他组差别显著 ,CT实测结果在大部分平面上与防腐湿肱骨及新鲜肱骨的结果无显著差别 ,与干肱骨组差别显著。结论 :肱骨髓内形状大体上接近于不规则圆柱体。     

Relations between radiograph texture analysis and microcomputed tomography in two rat models of bone metastases

AIMS: Osteolytic (Walker 256, W256) and osteoblastic (MatLyLu, MLL) metastases were induced to investigate their effect on bone architecture by microcomputed tomography (microCT) and texture analysis of radiographs. METHODS: Fischer and Copenhagen rats received an intracardiac injection with W256/MLL cells, respectively. Femur and tibia radiographs were analyzed by texture analysis with run lengths and fractal algorithms. Microarchitecture was analyzed on primary and secondary spongiosa by microCT. RESULTS: W256 and MLL induced a decrease of trabecular bone mass, a disconnection of trabeculae and an increased conversion of plates into pillars. On radiographs and 3-dimensional models of W256 rats, a disappearance of the primary spongiosa was observed. On radiographs and 3-dimensional models of MLL rats, osteolytic lesions were observed as disseminated dark areas. Run length and fractal analyses were altered in both metastases. CONCLUSION: W256 and MLL cells induced two different patterns of osteolysis. Texture analysis of radiographs is a useful technique to explore trabecular bone changes.     

成人股骨中下段的解剖学与扁弧形长针的设计应用

目的:通过对成人股骨远端解剖学参数测量及股骨骨髓腔观测,为扁弧形长针的设计及治疗股骨远端骨折提供形态学基础.方法:选用成人干燥股骨60根,平均分为2组,一组测量股骨长度、内外侧髁、内外上髁等有关数据,另一组测量股骨的密质厚度、髓腔内径及髓腔狭窄区、最远端断面皮质骨侧缘切线与中轴线所形成的夹角,并对测量结果进行统计分析.结果:股骨内侧髁宽度为(47.41±3.44)mm;股骨外侧髁宽度为(33.77±4.79)mm;股骨髁干角96.32°±2.30°;远端松质骨的长度为(50.00±7.90)mm;股骨干长度为(382±8.00)mm.成人股骨髓腔形态复杂,近远端呈漏斗状,而中间非松质骨部呈类柱体,中上段1/3部位最为狭窄,远端呈冠状面宽,而非松质骨部呈矢状面宽,且股骨髓腔具有一向前弧度.结论:股骨远端解剖学参数和股骨髓腔形态特点为扁弧形长针的设计研制和临床应用提供了解剖学依据;扁弧形长针其形态结构特点与髓腔顺应性好,可有效抗分离移位、抗旋转,操作简单,成本低廉,是治疗股骨远端骨折的有效内固定器械之一.     

Accounting for beta-particle energy loss to cortical bone via paired-image radiation transport (PIRT)

Current methods of skeletal dose assessment in both medical physics (radionuclide therapy) and health physics (dose reconstruction and risk assessment) rely heavily on a single set of bone and marrow cavity chord-length distributions in which particle energy deposition is tracked within an infinite extent of trabecular spongiosa, with no allowance for particle escape to cortical bone. In the present study, we introduce a paired-image radiation transport (PIRT) model which provides a more realistic three-dimensional (3D) geometry for particle transport in the skeletal site at both microscopic and macroscopic levels of its histology. Ex vivo CT scans were acquired of the pelvis, cranial cap, and individual ribs excised from a 66-year male cadaver (BMI of 22.7 kg m(-2)). For the three skeletal sites, regions of trabecular spongiosa and cortical bone were identified and segmented. Physical sections of interior spongiosa were taken and subjected to microCT imaging. Voxels within the resulting microCT images were then segmented and labeled as regions of bone trabeculae, endosteum, active marrow, and inactive marrow through application of image processing algorithms. The PIRT methodology was then implemented within the EGSNRC radiation transport code whereby electrons of various initial energies are simultaneously tracked within both the ex vivo CT macroimage and the CT microimage of the skeletal site. At initial electron energies greater than 50-200 keV, a divergence in absorbed fractions to active marrow are noted between PIRT model simulations and those estimated under existing techniques of infinite spongiosa transport. Calculations of radionuclide S values under both methodologies imply that current chord-based models may overestimate the absorbed dose to active bone marrow in these skeletal sites by 0% to 27% for low-energy beta emitters (33P, 169Er, and 177Lu), by approximately 4% to 49% for intermediate-energy beta emitters (153Sm, 186Re, and 89Sr), and by approximately 14% to 76% for high-energy beta emitters (32p, 188Re, and 90Y). The PIRT methodology allows for detailed modeling of the 3D macrostructure of individual marrow-containing bones within the skeleton thus permitting improved estimates of absorbed fractions and radionuclide S values for intermediate-to-high energy beta emitters.     

An image-based skeletal dosimetry model for the ICRP reference adult male--internal electron sources

In this study, a comprehensive electron dosimetry model of the adult male skeletal tissues is presented. The model is constructed using the University of Florida adult male hybrid phantom of Lee et al (2010 Phys. Med. Biol. 55 339-63) and the EGSnrc-based Paired Image Radiation Transport code of Shah et al (2005 J. Nucl. Med. 46 344-53). Target tissues include the active bone marrow, associated with radiogenic leukemia, and total shallow marrow, associated with radiogenic bone cancer. Monoenergetic electron emissions are considered over the energy range 1 keV to 10 MeV for the following sources: bone marrow (active and inactive), trabecular bone (surfaces and volumes), and cortical bone (surfaces and volumes). Specific absorbed fractions are computed according to the MIRD schema, and are given as skeletal-averaged values in the paper with site-specific values reported in both tabular and graphical format in an electronic annex available from http://stacks.iop.org/0031-9155/56/2309/mmedia. The distribution of cortical bone and spongiosa at the macroscopic dimensions of the phantom, as well as the distribution of trabecular bone and marrow tissues at the microscopic dimensions of the phantom, is imposed through detailed analyses of whole-body ex vivo CT images (1 mm resolution) and spongiosa-specific ex vivo microCT images (30 μm resolution), respectively, taken from a 40 year male cadaver. The method utilized in this work includes: (1) explicit accounting for changes in marrow self-dose with variations in marrow cellularity, (2) explicit accounting for electron escape from spongiosa, (3) explicit consideration of spongiosa cross-fire from cortical bone, and (4) explicit consideration of the ICRP's change in the surrogate tissue region defining the location of the osteoprogenitor cells (from a 10 μm endosteal layer covering the trabecular and cortical surfaces to a 50 μm shallow marrow layer covering trabecular and medullary cavity surfaces). Skeletal-averaged values of absorbed fraction in the present model are noted to be very compatible with those weighted by the skeletal tissue distributions found in the ICRP Publication 110 adult male and female voxel phantoms, but are in many cases incompatible with values used in current and widely implemented internal dosimetry software.     

正常维吾尔族成年人股骨上段的X线解剖及其临床意义

目的了解维吾尔族正常成年人股骨上段X线解剖特征.方法拍摄36例正常维吾尔族成年人双侧股骨上段标准正位片,对股骨头直径、股骨头颈长度、股骨头高、小转子上20 mm平面处髓腔宽度、小转子处髓腔宽度、小转子下20 mm平面处髓腔宽度、狭窄处位置、狭窄处髓腔左右宽度8项指标进行测量并进行统计学处理.结果股骨上段各项指标间无侧别差异（P〉0.05）;男、女性股骨头直径、股骨头高、小转子下20 mm平面处髓腔宽度等指标存在性别差异（P〈0.05）;与汉族相比股骨头直径、股骨头颈长度、狭窄处位置、狭窄处髓腔宽度等指标存在种族差异（P〈0.05）,与外国人相比股骨头直径、股骨头颈长度、小转子上20 mm平面处髓腔宽度、小转子处髓腔宽度、狭窄处髓腔左右宽度等指标存在种族差异（P〈0.05）.结论维吾尔族正常成年人骨股上段结构有其特点,可为临床应用提供依据.     

Response functions for computing absorbed dose to skeletal tissues from photon irradiation--an update

A comprehensive set of photon fluence-to-dose response functions (DRFs) is presented for two radiosensitive skeletal tissues-active and total shallow marrow-within 15 and 32 bone sites, respectively, of the ICRP reference adult male. The functions were developed using fractional skeletal masses and associated electron-absorbed fractions as reported for the UF hybrid adult male phantom, which in turn is based upon micro-CT images of trabecular spongiosa taken from a 40 year male cadaver. The new DRFs expand upon both the original set of seven functions produced in 1985, and a 2007 update calculated under the assumption of secondary electron escape from spongiosa. In this study, it is assumed that photon irradiation of the skeleton will yield charged particle equilibrium across all spongiosa regions at energies exceeding 200 keV. Kerma coefficients for active marrow, inactive marrow, trabecular bone and spongiosa at higher energies are calculated using the DRF algorithm setting the electron-absorbed fraction for self-irradiation to unity. By comparing kerma coefficients and DRF functions, dose enhancement factors and mass energy-absorption coefficient (MEAC) ratios for active marrow to spongiosa were derived. These MEAC ratios compared well with those provided by the NIST Physical Reference Data Library (mean difference of 0.8%), and the dose enhancement factors for active marrow compared favorably with values calculated in the well-known study published by King and Spiers (1985 Br. J. Radiol. 58 345-56) (mean absolute difference of 1.9 percentage points). Additionally, dose enhancement factors for active marrow were shown to correlate well with the shallow marrow volume fraction (R(2) = 0.91). Dose enhancement factors for the total shallow marrow were also calculated for 32 bone sites representing the first such derivation for this target tissue.     

颞骨岩尖部及其邻近结构的应用解剖学研究

目的 观测颅底外岩尖部的解剖结构，为颅脑外科、耳鼻喉科等颅底手术提供解剖学依据。方法 采用游标卡尺和厚度测量仪，观测100侧成人颅骨标本，观察63侧颞骨颈动脉管在岩尖部走行、位置及骨质结构特点。结果 岩尖部外面境界距离均数分别为：内侧缘左0．68cm，右0．73cm；外侧缘左1．46cm，右1．41cm；前缘左1．08cm，右2．18cm；后缘左0．68cm，右0．73cm；测量了颈动脉管在岩尖部骨质内的有关数据；观察了岩尖部骨质结构特征并按气化程度进行分型。结论颈动脉管在岩尖部走行位置偏前靠上，上壁最薄，下壁厚度变异大；岩尖部骨质以硬化型居多，占42％。     

Skeletal dosimetry in the MAX06 and the FAX06 phantoms for external exposure to photons based on vertebral 3D-microCT images

3D-microCT images of vertebral bodies from three different individuals have been segmented into trabecular bone, bone marrow and bone surface cells (BSC), and then introduced into the spongiosa voxels of the MAX06 and the FAX06 phantoms, in order to calculate the equivalent dose to the red bone marrow (RBM) and the BSC in the marrow cavities of trabecular bone with the EGSnrc Monte Carlo code from whole-body exposure to external photon radiation. The MAX06 and the FAX06 phantoms consist of about 150 million 1.2 mm cubic voxels each, a part of which are spongiosa voxels surrounded by cortical bone. In order to use the segmented 3D-microCT images for skeletal dosimetry, spongiosa voxels in the MAX06 and the FAX06 phantom were replaced at runtime by so-called micro matrices representing segmented trabecular bone, marrow and BSC in 17.65, 30 and 60 microm cubic voxels. The 3D-microCT image-based RBM and BSC equivalent doses for external exposure to photons presented here for the first time for complete human skeletons are in agreement with the results calculated with the three correction factor method and the fluence-to-dose response functions for the same phantoms taking into account the conceptual differences between the different methods. Additionally the microCT image-based results have been compared with corresponding data from earlier studies for other human phantoms.