双源CT三维重建评价前交叉韧带骨道位置的临床研究 |
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引用本文: | 张强,江亚,王立飞,刘群,杨祖华. 双源CT三维重建评价前交叉韧带骨道位置的临床研究[J]. 中华关节外科杂志(电子版), 2013, 0(6): 29-32 |
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作者姓名: | 张强 江亚 王立飞 刘群 杨祖华 |
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作者单位: | 合肥市第三人民医院骨科,230022 |
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摘 要: | 目的 探讨双源CT三维重建前交叉韧带(ACL)股骨止点自然印迹与骨道中心点相对位置关系.方法 分别对55例志愿者110个膝关节和30例双束重建患者30个患膝关节进行双源CT扫描.使用CT图像后处理工作站行三维重建膝关节股骨外髁内侧壁三维模型,再现股骨外髁内侧壁ACL自然印迹及术后双束骨道,标记、测量自然印迹及骨道中心点相对位置,比较两者的位置关系,显著性差异设定P值0.05.结果 ACL自然印迹中心点相对位置与术后双束骨道中心点相对位置比较:前内束,h对=(26.2±2.2)%,h实=(23.6±8.5)%,中心点相对位置比较有统计学差异(t=4.906,P〈0.01);t对=(25.0±2.1)%,t实=(25.2±3.9)%,中心点相对位置比较无统计学差异(t=0.480,P〉0.05).后外束,h对=(46.5±3.2)%,h实=(45.0±4.6)%,中心点相对位置比较无统计学差异(t=0.608,P〉0.05);t对=(34.2±2.5)%,t实=(37.9±4.2)%,中心点相对位置比较无统计学差异(t=0.530,P〉0.05).结论 (1) DSCT三维重建可清晰重建出ACL股骨止点自然印迹和双束重建术后骨道位置;(2) DSCT 三维重建可用于ACL解剖双束重建术后骨道位置评估,对改进关节镜下ACL解剖双束重建有指导意义.
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关 键 词: | 前交叉韧带 股骨 体层摄影术 X线计算机 成像 三维 胫骨 |
Clinical research on femoral tunnels for anterior cruciate ligament reconstruction by dual-source CT three-dimensional reconstruction |
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Affiliation: | ZHANG Qiang, JIANG Ya, WANG Li-fei, LIU Qun, YANG Zu-hna.( Department of Orthopaedics, The Third People Hospital, Hefei 230022, China) |
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Abstract: | Objective To compare the natural footpoints centers and the femoral tunnel apertures centers by dual-source computed tomography (DSCT) three-dimensional(3-D) reconstruction. Methods DSCT scans were performed on 55 pairs of knees ( 110 knees) and 30 double-bundle reconstructed knees after the arthroscopic double-bundle reconstruction of ACL. The 3-D reconstruction of the lateral wall of the intercondylar notch was done with 64-slice spiral CT workstation ( GE, Volume Share2-AW 4.4 version). The double-bundle footprints of the ACL femoral insertions and the double-bundle femoral tunnels were identified. The centers of ACL natural footprints and the femoral double-bundle tunnels were marked; the relative locations were compared. P 〈 0. 05 was considered significant. Results The comparison of the relative locations of ACL natural footprints centers and the double-bundle tunnels: ( 1 ) Anteromedial bundle (AMB) : hC = ( 26. 2 ± 2. 2 ) %, hE = ( 23.6 ± 8.5 ) % , there was significant difference ( t = 4. 906, P 〈 0. 01 ) ; tC = (25.0 ± 2. 1 ) %, tE = (25.2 ± 3.9) %, there was no significant difference ( t = 0. 480, P 〉 0. 05 ). ( 2 ) Posterolateral bundle ( PLB ) : hC = ( 46. 5 ± 3.2 ) %, hE = (45.0 ± 4. 6 ) %, there was no significant difference ( t = 0. 608, P 〉 0. 05 ) ; tC = ( 34. 2 ± 2. 5 ) % , tE = ( 37.9 ± 4. 2 ) % , there was no significant difference ( t = 0. 530, P 〉 0. 05 ). Conclusions ( 1 ) The ACL natural footprints of the femoral insertions and the femoral tunnels of the ACL double-bundle reconstruction were identified by DSCT 3-D reconstruction. (2)The 3-D reconstruction of DSCT can help evaluating the relative locations of anatomical double-bundle reconstructed tunnels of the ACL, which can provide meaningful guidance for arthroscopic anatomical double-bundle reconstruction of the ACL. |
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Keywords: | Anterior cruciate ligament Femur Tomography, X-ray computed Imaging, threedementional Tibia |
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