兔肩关节前向不稳实验模型的建立

目的:建立研究肩关节不稳的动物(兔)模型,为进行相关研究提供实验依据。方法:取6只骨骼成熟的雄性新西兰大白兔进行肩关节正常组织结构的解剖,研究手术入路。通过解剖兔的肩关节并测量其关节活动度,了解兔肩关节与人肩关节骨骼、周围肌肉组织及关节囊韧带组织的类似程度,建立兔肩关节不稳动物模型的手术入路及手术方法。另取18只兔分为2组,其中12只为实验组,均取右侧肩关节,手术切开肩胛下肌腱显露盂肱关节,并切除前下方盂缘及其相连的韧带组织,制作肩关节前方不稳模型,分别于术后6周及12周(各6只)取材;其余6只为对照组,仅切开皮肤及浅层肌肉组织,于术后12周取材。测量盂肱关节活动度及稳定性。结果:兔肩关节大体解剖与人类相类似,实验组兔关节前向稳定性明显差于对照组,所有实验组肩关节均有2度以上的前向不稳定存在。实验组兔肩关节后伸、内旋、外旋及外展活动明显受限,而对照组肩关节活动基本正常。结论:兔是建立肩关节不稳动物模型和进行相关实验研究的合适动物,本实验建立的兔肩关节前向不稳模型适用于盂肱关节前向不稳的研究。     

肩关节损伤的MR影像诊断

目的 探讨常规MRI和MR间接关节造影对肩关节损伤的诊断价值.方法 回顾分析经关节镜证实的90例肩关节损伤患者肩关节常规MRI和MR问接关节造影表现,其中肩袖病变组57例、盂肱关节不稳组33例.对常规MRI和MR间接关节造影诊断结果进行Fisher确切概率法比较.结果 (1)肩袖病变组中MR间接关节造影37例,显示部分撕裂10例,1例漏诊;显示完全撕裂17例,2例误诊,7例肩袖无撕裂.MR间接关节造影显示部分撕裂的敏感度、特异度、准确度分别为90.9%(10/11)、92.3%(24/26)、91.9%(34/37);显示完全撕裂的敏感度、特异度、准确度分别为89.5%(17/19)、94.4%(17/18)、91.9%(34/37).MR间接关节造影诊断肩袖部分及完全撕裂的敏感度及准确度均高于常规MRI(P<0.05).(2)盂肱关节不稳组中,盂唇损伤26例,Hill-sachs病变27例、反Hill-sachs病变2例、骨陛Bankart损伤7例、关节囊损伤18例.间接关节造影20例,显示盂唇损伤14例,1例漏诊,5例正常.MR间接关节造影显示盂唇损伤的敏感度、特异度、准确度分别为93.3%(14/15)、100.0%(5/5)、95.0%(19/20).前者诊断盂唇损伤的敏感度及准确度明显高于常规MRI(P<0.05).结论 MR检查特别是MR间接关节造影能够准确显示肩关节常见病变及相关组织的病理发展过程,为临床诊断及治疗提供影像学依据.     

盂肱下韧带MR影像对冻结肩的诊断价值

目的探讨盂肱下韧带MR表现对冻结肩的诊断价值。方法分析我院间141例肩关节MR影像,将临床诊断为冻结肩48例患者作为冻结肩组、经关节镜证实的肩袖部分撕裂37例患者作为肩袖撕裂组、正常对照组56例。在斜冠状位T_2WI脂肪饱和序列上评估盂肱下韧带T_2信号强度、有无关节囊外高信号层并测量盂肱下韧带厚度。结果盂肱下韧带T_2WI脂肪饱和序列上呈高信号:冻结肩组41例、肩袖撕裂组5例、对照组5例,其诊断冻结肩的准确性88%、敏感性85%、特异性89%、阳性预测值80%、阴性预测值92%;斜冠状位T_2WI脂肪饱和序列上盂肱下韧带厚度:冻结肩组(n=48)(5.22±1.03)mm、肩袖撕裂组(n=37)(3.95±0.69)mm、对照组(n=56)(3.96±0.72)mm,冻结肩组厚度明显大于肩袖撕裂组、对照组,差异比较具有统计学意义(P0.001),肩袖撕裂组与对照组差异比较无统计学意义(P0.05)。结论盂肱下韧带T_2WI脂肪饱和序列上信号增高、增厚表现有助于冻结肩诊断。     

超声定量评估髋关节前上盂唇面积及关节囊厚度的可行性研究

目的:探讨超声测量无症状人群髋关节前上盂唇截面积(CSA)、前关节囊厚度测量重复性.方法:测量40位(80髋)无髋关节症状患者髋关节前上盂唇CSA及前关节囊厚度.男20人,女20人,年龄21～49岁,平均32.4±8.2岁.2位超声医师分别测量髋关节前上盂唇CSA、前关节囊厚度.采用组内相关系数(ICC)评价测量重复性...     

非创伤性寰枕关节失稳的CT表现及相关因素分析

目的 探讨非创伤性寰枕关节失稳的CT表现.资料与方法 回顾性分析182例颈椎CT平扫患者资料,原始图像经后处理工作站行多平面重组(MPR),重点观察寰枕关节形态和关节失稳的CT表现.结果 21例(11.54%)寰枕关节失稳患者均无明确外伤史,其中单侧枕骨髁后旋转型失稳13例,单纯后移位型失稳5例,后移位-旋转复合型失稳3例.矢状面MPR均表现为关节前缘骨皮质连线向后角折,关节面呈阶梯状改变,7例冠状面MPR示双侧寰枕关节同向错动;11例横断面MPR示"窄三角形间隙征".15例显示寰椎上关节突后部平坦.结论 薄层螺旋CT扫描并MPR技术可充分显示寰枕关节的形态学特征,寰椎上关节突后部平坦和矢状面MPR枕骨髁向后移位超过2 mm是诊断寰枕关节失稳的重要征象.     

椎弓根角及椎小关节退行性变与腰椎椎体滑脱的相关性研究

目的 通过测量退行性腰椎滑脱(DS)的小关节有关数据,观察小关节面的改变,探讨引起退行性腰椎滑脱的可能局部因素.方法 应用64层螺旋CT对退行性L4～5腰椎滑脱的28例患者(滑脱组)与腰部疼痛但无腰椎滑脱的78例患者(对照组)的CT图像作小关节形态及其结构特点的对比分析.测量小关节椎弓根角、椎间小关节角角度,对所获的数据进行2组兼得参数t检验分析.结果 DS组L4～5矢状面椎弓根角平均值为左侧119.0°±2.2°、右侧118.8°±1.9°,对照组分别为左侧102.9°±1.2°、右侧104.7°±1.2°;滑脱组L4～5轴面小关节角平均值为左侧41.1°±1.2°、右侧29.0°±1.2°,对照组平均值分别为左侧45.5°±2.1°,右侧45.1°±1.2°.两组L4～5小关节椎弓根角、小关节夹角的差异均有统计学意义(P值均<0.05).结论 L4～5矢状面椎弓根角和轴面小关节角的改变对诊断退行性腰椎滑脱有重要意义.     

颈椎关节突关节摄影位置的研究

目的研究一种能够显示颈椎上、下关节突及关节突关节的最佳摄影位置。方法测量63例正常人颈椎关节突关节(第3~7颈椎)CT横断扫描片(920个有效数据),在颈椎关节突关节CT片上做椎体前后缘中点连线的延长线和颈椎上关节突关节面两端点连线的延长线,两直线相交所形成的夹角即人体矢状面与颈椎关节突关节的角度,称颈椎关节突关节角。结果颈椎关节突关节角为70°~75,°经统计学处理,颈椎的关节突关节在不同性别、不同椎体、不同侧别之间无明显差异。在摄影时,使人体冠状面与胶片成70°~75°摄片,此时关节突关节与胶片垂直,与中心线平行,可得到清晰的关节突关节影像,此摄影位置称颈椎关节突关节位。结论颈椎关节突关节位能清晰显示颈椎上、下关节突及关节突关节间隙。     

脑卒中后早期偏瘫肩痛与肩关节被动活动度相关性分析

目的:确定脑卒中后3个月内偏瘫肩痛与肩关节各方向被动活动度之间的相关性。方法:共收集40例首次脑卒中后3个月内单侧偏瘫肩痛患者,年龄58.63±11.10岁,病程59.90±30.12天;男31例,女9例。采用通用量角器测量卒中偏瘫侧肩关节前屈、外展、外旋、内旋、后伸5个方向的被动活动度(ROM),再行视觉模拟疼痛评分(VAS)、上肢Fugl-Meyer运动评测量表(UE-FM)、Barthel指数(BI)测量,并分析VAS评分与其他评估结果之间的相关性。结果:偏瘫侧肩关节前屈、外展、外旋、内旋、后伸5个方向的被动ROM与VAS相关,Pearson相关系数分别为-0.345、-0.323、-0.359、-0.319和-0.317(P<0.05)。上肢Fugl-Meyer运动评测量表和Barthel指数与VAS相关性无统计学意义(P>0.05)。结论:脑卒中早期偏瘫肩痛与肩关节5个方向的被动活动度之间有明显相关性,尤其在被动外旋上。     

基于肩关节骨性关节盂后下部最大拟合圆采用径线缺损比例法评价关节盂形态的可靠性研究

目的:评估基于肩关节骨性关节盂后下部最大拟合圆的关节盂形态评价方法的可靠性,为提高临床工作及相关研究的准确性提供依据。方法:入组人群为成年人,无肩关节脱位病史,无肩关节畸形等其他可能导致关节盂形态异常的因素。共40例患者(80例关节盂)纳入本研究。入组人群因非脱位导致的肩关节不适进行包含双侧肩关节盂的CT检查。对层厚、层间距为1 mm的关节盂图像进行VR重建,旋转至En-face位。对图像采用径线缺损比例法进行评价。3位资历不同的医师基于关节盂后下部绘制拟合圆,测量并记录拟合圆的半径(R)、关节盂前缘距圆心最近点的距离(D),计算径线缺损量与拟合圆直径之比[F=(R-D)/2R*100%]。测量3次取平均值作为该测量者该次关节盂测量结果。上述测量共进行2次,测量间隔3个月以上。采用组内相关系数分析比较同一医师不同次测量及各医师间测量结果的差异,ICC值大于0.75认为可靠性良好,ICC值小于0.4认为可靠性不佳,ICC值介于0.4与0.75之间认为可靠性一般。结果:共40名患者(80个关节盂)纳入研究。采用组内相关系数分析,每名医师不同次测量中各参数ICC大于0.9,可靠性好;各医师间测量结果R、D的ICC值介于0.4至0.75之间,可靠性一般;F的ICC值小于0.2,可靠性不佳。结论:基于关节盂后下部最大拟合圆采用径线缺损比例法评价关节盂形态这一方法,同一测量者测量可重复性好,但测量者间可靠性不佳。可采用多名测量者测量并求取均值方案以保证结果的可信度。通过测量径线缺损比例的方法不能真实准确地反映关节盂缺损情况,在临床工作及研究中应谨慎使用。     

颞下颌关节滑膜软骨瘤病的MRI表现

目的:探讨和描述颞下颌关节(TMJ)滑膜软骨瘤病的MRI表现特点。材料和方法:回顾性观察和分析13例经手术病理证实的TMJ区滑膜软骨瘤病的MRI表现。所有病例均在术前行闭口矢状面和冠状面PDWI、开口矢状面T_2WI检查。结果:所有滑膜软骨瘤病均发生于TMJ上腔。病变的MRI表现:关节上腔异常积液(13例,100%);关节囊明显扩张(11例,84.6%);关节腔内有多发软骨样小体的形成(11例,84.6%);关节囊或滑膜组织增厚(8例,61.5%)和颞骨关节面骨质破坏(4例,30.8%)。MRI未显示病变有下颌髁突侵蚀、关节囊外软组织侵犯、大脑颞叶脑膜和脑实质侵犯。结论:颞下颌关节滑膜软骨瘤病的MRI表现具有一定特点,主要表现为关节上腔异常积液,伴关节囊扩张、多发软骨样结节小体形成和滑膜组织增厚。     

360° arthroscopic capsular release in patients with adhesive capsulitis of the glenohumeral joint – indication, surgical technique, results

Adhesive capsulitis of the glenohumeral joint is said to be a self-limiting process. However, in some patients the disease can last much longer than 1 year, which may lead patients to more invasive treatment than merely undergoing physiotherapy. Other patients do not accept this severe limitation and choose treatment options that restore the range of motion (ROM) more rapidly. Conventional open release techniques generally improve motion but involve extensive dissection. The purpose of this study was to develop a safe and reproducible technique of arthroscopic capsular release (ACR) and to present the results of this technique in the clinical situation. The technique for ACR was first defined in a cadaver study and then applied in 28 patients with primary adhesive capsulitis of the glenohumeral joint. The patients were selected for the arthroscopic release when conservative therapy had failed for at least 6 months. All of the patients had a global loss of shoulder motion and had motion restored with a combined anterior, posterior, superior, and inferior release of the of the capsule (360 degrees release). Additionally, in all patients synovectomy with electrocautery was performed. We documented the ROM in the different planes as well as the Constant score. The Constant score improved a mean of 41 points. Range of motion for all planes significantly improved (P < 0.01). Abduction improved from 75 degrees preoperatively to 165 degrees intraoperatively; 6 weeks after surgery, mean abduction was 168 degrees and at the time of follow-up it was 167 degrees. Mean external rotation in adduction improved from 3 degrees preoperatively to 75 degrees intraoperatively. After 6 weeks, the mean external rotation in adduction was 72 degrees and at the time of follow-up the external rotation reached 76 degrees. Mean external rotation in abduction improved from 4 degrees preoperatively to 81 degrees intraoperatively, 80 degrees after 6 weeks and 85 degrees at the time of the last follow-up. Internal rotation in abduction was 17 degrees preoperatively. Intraoperatively, mean internal rotation was 59 degrees. An angle of 58 degrees was documented at 6 weeks follow-up, and at the last follow-up an angle of 63 degrees was documented. No postoperative lesion of the axillary nerve was present. We concluded that arthroscopic capsular release is a reliable method for restoring motion with minimum morbidity in carefully selected patients. When performing an ACR the incision of the glenohumeral joint capsule should be undertaken at the glenoidal insertion in the abducted and external rotated shoulder.     

Static capsuloligamentous restraints to superior-inferior translation of the glenohumeral joint.

The purpose of this study was to determine the contributions of specific capsuloligamentous structures to restraining superior-inferior translation of the glenohumeral joint. Eleven cadaveric shoulders were tested using a four degrees-of-freedom test apparatus. The humerus was free to translate in three planes and free to flex and extend when a superior and inferior force of 50 N was applied. Testing was performed in three positions of abduction (0 degree, 45 degrees, and 90 degrees) and three positions of rotation (neutral, maximum internal, and external). Shoulders were tested intact, vented, and after division of specific capsuloligamentous structures. The primary restraint to inferior translation of the adducted shoulder was the superior glenohumeral ligament. The coracohumeral ligament appeared to have no significant suspensory role. With progressive abduction, the anterior and posterior portions of the glenohumeral ligament become the main static stabilizers resisting inferior translation: the anterior portion was the primary capsular restraint at 45 degrees of abduction, while the posterior portion was the primary restraint at 90 degrees of abduction, neutral rotation. Our results indicate that clinical assessment of glenohumeral translation in the superior-inferior plane should be performed in multiple positions of abduction and rotation.     

Scapulohumeral rhythm in patients after total shoulder arthroplasty compared to age-matched healthy individuals

PurposeThe coordination of the glenohumeral joint and the shoulder girdle has been known as scapulohumeral rhythm. The effects of anatomical total shoulder arthroplasty (aTSA) are still subject to research. Former studies showed a higher amount of scapula lateral rotation to compensate for reduced glenohumeral elevation. The purpose of the present study was to confirm this mechanism and examine additional effects on the sternoclavicular and acromioclavicular joints’ kinematics.Methods3D motion analysis was used to examine 23 shoulders of 16 patients with a mean age of 71.2 (SD: 5.2) years with a mean follow up of 5.4 (SD: 2.1) years after aTSA and to compare kinematics and coordination to 22 shoulders of 11 healthy age-matched individuals with a mean age of 69.6 (SD: 5.3) years while performing elevation movement in frontal and sagittal plane.ResultsThe ratio of glenohumeral to shoulder girdle contribution was reduced compared to healthy individuals: Shoulder girdle contribution to elevation was 36.5% (SD: 8.1) in the aTSA group vs. 28.5% (SD: 8.2) in the control group in the sagittal plane and 38.1% (SD: 9.1) vs. 30.2% (SD: 7.1) in the frontal plane. Kinematics of the sternoclavicular and acromioclavicular joints showed significantly different patterns.ConclusionPatients after aTSA showed altered shoulder girdle kinematics and higher contribution of the shoulder girdle towards elevation. Whether this is a result of the surgery, of limited glenohumeral range of motion or due to the preoperative status remains unclear. Further investigation with a prospective study design is necessary.     

Scapular muscles weakness in subjects with traumatic anterior glenohumeral instability

ObjectiveTo investigate possible alterations on scapular muscle strength in subjects with traumatic anterior glenohumeral instability.DesignCross-sectional study. Setting: Laboratory setting. Participants: Fifty-two subjects of both sexes: 26 healthy and 26 with traumatic anterior glenohumeral instability.Main outcome measuresSubjects performed maximal isometric and concentric isokinetic contractions of shoulder protraction and retraction in scapular and sagittal planes, at slow (12.2 cm/s) and fast (36.6 cm/s) speeds.ResultsSubjects with glenohumeral instability presented lower peak force of protraction and retraction during isometric and fast speed tests in the scapular plane; and of isometric protraction in the sagittal plane.ConclusionsPeople with traumatic anterior glenohumeral instability present muscle weakness of scapular protractors and retractors. Considering the importance of the scapulothoracic muscles for the dynamic stability of the glenohumeral joint, strengthening of these muscles is recommended for rehabilitation of traumatic anterior glenohumeral instability.     

Gender differences in frontal and sagittal plane biomechanics during drop landings

PURPOSE: To determine gender differences in lower-extremity joint kinematics and kinetics between age- and skill-matched recreational athletes. METHODS: Inverse dynamic solutions estimated the lower-extremity flexion-extension and varus-valgus kinematics and kinetics for 15 females and 15 males performing a 60-cm drop landing. A mixed model, repeated measures analysis of variance (gender (*) joint) was performed on select kinematic and kinetic variables. RESULTS: Peak hip and knee flexion and ankle dorsiflexion angles were greater in females in the sagittal plane (group effect, P < 0.02). Females exhibited greater frontal plane motion (group (*) joint, P = 0.02). Differences were attributed to greater peak knee valgus and peak ankle pronation angles (post hoc tests, P = 0.00). Females exhibited a greater range of motion (ROM) in the sagittal plane (group main effect, P = 0.02) and the frontal plane (group (*) joint, P = 0.01). Differences were attributed to the greater knee varus-valgus ROM, ankle dorsiflexion, and pronation ROM (post hoc tests). Ground reaction forces were different between groups (group (*) direction, P = 0.05). Females exhibited greater peak vertical and posterior (A/P) force than males (post hoc tests). Females exhibited different knee moment profiles (Group main effect, P = 0.01). These differences were attributed to a reduced varus moment in females (post hoc tests). CONCLUSION: The majority of the differences in kinematic and kinetic variables between male and female recreational athletes during landing were observed in the frontal plane not in the sagittal plane. Specifically, females generated a smaller internal knee varus moment at the time of peak valgus knee angulation.     

火绒草对2型糖尿病大鼠糖脂代谢的影响

目的 观察火绒草对2型糖尿病大鼠血糖、血脂代谢的影响。方法采用高糖高脂饮食诱导联合链脲佐菌素（STZ）腹腔注射建立2型糖尿病大鼠模型,将Wistar大鼠随机分为正常组,糖尿病模型组,火绒草低剂量组（10g/kg）,火绒草高剂量组（20g/kg）,西格列汀组（10mg/kg）,连续给药4周后分别检测各组大鼠的体重、空腹血糖、空腹胰岛素、甘油三酯和胆固醇,并行葡萄糖耐量试验。结果与糖尿病模型组大鼠相比,火绒草高剂量组糖尿病空腹血糖、甘油三酯、胆固醇水平、葡萄糖耐量曲线下面积显著降低,胰岛素水平显著升高,且效果优于火绒草低剂量组和西格列汀组。结论火绒草可显著降低2型糖尿病大鼠的血糖水平,改善血脂紊乱。     

Roux-en-Y胃转流术对GK大鼠炎症因子与胰岛素抵抗影响的实验研究

目的探讨Roux-en-Y胃转流术对自发糖尿病GK大鼠炎症因子与胰岛素抵抗的影响及其意义。方法 40只GK大鼠随机平均分为手术组与对照组。手术组行Roux-en-Y胃转流术,对照组行胃窦十二指肠离断后原位吻合术。分别于术前,术后1、2、4周动态检测两组大鼠血液中空腹血糖、口服葡萄糖耐量试验(OGTT)2 h血糖,空腹胰岛素;并于术前及术后4周测定大鼠血液中游离脂肪酸(free fatty acids,FFA)、肿瘤坏死因子α(TNF-α)、C-反应蛋白(CRP),计算胰岛素抵抗指数(HOMA-IR)。结果手术组术后空腹及OGTT2h血糖值均呈明显的下降趋势,至术后第4周时其血糖值显著低于术前(9.8±2.6)mmol/L降至(7.3±2.2)mmol/L及OGTT2h血糖(27.3±3.1)mmol/L降至(23.6±3.4)mmol/L(P<0.05);对照组手术前后空腹及OGTT2h血糖值无显著变化(P>0.05)。术后第4周,手术组大鼠血液FFA较术前显著降低(204.2±55.6)umol/L降至(179.4±32.54)umol/L(P<0.05);术后4周血中TNF-α的含量较术前显著降低(32.4±1.3)pg/ml降至(24.9±1.0)pg/ml(P<0.01);术后4周CRP的含量显著低于术前(648.5±36.23)ng/ml降至(32.9±37.8)ng/ml(P<0.01);而手术前后空腹胰岛素水平无显著变化(P>0.05),其HOMA-IR指数较术前显著降低(8.46±1.66降至5.20±0.79)(P<0.05);而对照组术后4周上述指标无显著差异(P>0.05)。结论 Roux-en-Y胃转流术能显著降低GK大鼠的血糖,其可能机制是手术后通过降低体内游离脂肪酸含量,导致炎症因子释放减少,从而使胰岛素抵抗得到缓解。     

Three-dimensional kinetic analysis of running: significance of secondary planes of motion

PURPOSE: The study of angular kinetic data provides important information regarding muscle function and may lend insight into the etiology of overuse injuries common to runners. These injuries are often due to deviations in the secondary planes of motion. However, little is known about the angular kinetics in these planes leaving no reference for comparison. METHODS: Therefore, three-dimensional kinematic and ground reaction force data were collected on 20 recreational runners with normal rearfoot mechanics. RESULTS: Findings suggest that sagittal plane kinetic data were similar to the two-dimensional studies reported in the literature. Sagittal plane data were least variable (CV: 9.3-11.0%) and comprised the largest percentage of positive or negative work done (80.2-88.8%) at both the rearfoot and knee joints. Transverse plane kinetics were most variable (CV: 68.5-151.9%) and constituted the smallest percentage of work done at both joints (0.7-7.4%). CONCLUSIONS: Although relatively smaller than the sagittal plane component, a substantial amount of positive work was done in the frontal plane at both joints (16.1-18.9%), suggesting that this component should not be ignored.     

Regional cerebral glucose metabolism in healthy volunteers determined by fluordeoxyglucose positron emission tomography: appearance and variance in the transaxial, coronal, and sagittal planes

PURPOSE: In this study, the contribution of the transaxial, coronal, and sagittal planes in evaluations of regional cerebral glucose metabolism was investigated in healthy volunteers as determined by fluorine-18-labeled 2-deoxy-2-fluoro-D-glucose (FDG) and high-resolution positron emission tomography (PET). METHODS: One hundred twenty-seven healthy right-handed volunteers were injected with 4.2 MBq/kg (0.11 mCi) body weight FDG and imaged in a PENN PET H 240 scanner. Images were corrected for scatter and random coincidences and reconstructed in all three planes into 6- to 8-mm-thick slices. The reconstructed images were corrected for attenuation using the Chang algorithm. The transverse, coronal, and sagittal images were read independently of each other using a qualitative scale in which 1 = equal to, 2 = mildly, 3 = moderately, and 4 = markedly less than the area with the highest glucose metabolism in the respective plane. RESULTS: The areas with the highest glucose metabolisms were the posterior cingulate gyri with mean scores of 1.1 to 1.2, thalami (1.2 to 1.3), basal ganglia (1.5 to 1.9), and visual cortex (1.6). The lowest values were found in the occipital cortex (2.7 to 2.8) and the cerebellum (2.3 to 2.4). Whereas reliable analysis of the mesial temporal aspects was not feasible in the sagittal plane, the anterior poles of the temporal and frontal lobes could not be evaluated in the coronal or the inferior temporal areas in the transaxial slices. In all three planes, regional glucose metabolism was less in the lateral temporal areas on the left than on the right (P < 0.001). The consistency of readings as measured in terms of coefficients of variation was greatest in the coronal plane for the caudates and posterior cingulate gyri, in the transaxial plane for the lateral temporal regions, and in the sagittal plane for the visual cortex. Age-dependent decreases in regional glucose metabolism in the inferior and lateral frontal regions and the parietal lobes were found in all three planes. CONCLUSIONS: All three projection planes must be used for a comprehensive qualitative evaluation of the regional glucose metabolism of the brain.