基于CT三维重建的肩胛上角形态学分型及临床意义

目的　探讨基于CT重建的肩胛上角形态学分型及临床意义。 方法　根据志愿者肩胛骨CT重建形态进行分型。设肩胛上角为A点，肩胛切迹最低点为B点，肩胛冈与肩胛骨内侧缘之交点为C点，A点在CE连线上的垂点为D点，冈盂切迹为E点，肩胛下角最低点为F点。研究参数：A点厚度；AB、AC、AD距离；∠A（AB连线与AC连线的夹角）；∠ACF在矢状面的度数；∠ACF在冠状面的度数。 结果　CT重建下肩胛上角分为3型：山丘型48%，冠状面∠A（93.76±7.69）°；山峰型47%，冠状面∠A（86.69±6.23）°；烟囱型5%，冠状面∠A（85.33±7.10）°。其中，山丘型及烟囱型A点均较山峰型薄（P<0.05）；在AB、AC、AD、∠A、∠ACF（冠状面）中，山丘型与山峰型对比有统计学差异（P<0.05）；在AD、∠A中，山丘型与烟囱型对比有统计学差异（P<0.05）。 结论　CT重建下肩胛上角分为3型：山丘型、山峰型、烟囱型；不同的肩胛上角分型可能对颈肩痛及肩胛提肌综合症有着潜在的影响。

The morphological classification and clinical significance of the angulus superior scapulae based on CT three-dimensional reconstruction

Objective　To explore the morphological classification and the clinical significance of the angulus superior scapulae based on CT three-dimensional reconstruction.　Methods　The CT three-dimensional reconstruction of scapular was classified according to the morphological characteristics. Reference points: A, the angulus superior scapulae; B, the lowest point of the scapular notch; C, the intersection between the scapula and the inner margin of the scapula; D, the vertical point of the point A on the line CE; E, the spinoglenoid notch; F, the lowest point of the subscapular angle. Parameters studied: the thickness of point A; the distance of AB, AC and AD; the angle of ∠A (the angle between the straight line AB and the straight line AC); the angle of ∠ACF in sagittal plane; the angle of ∠ACF in coronal plane.　Results　Under the CT three-dimensional reconstruction, the superior scapulae was classified into three types: Hilly type 48%, ∠A =(93.76±7.69)°; Mountain peak type 47%, ∠A=(86.69±6.23)°; and Chimney type 5%, ∠A =(85.33±7.10)°. Among them,the thickness of point A of Hill type and Chimney type was thinner than Mountain peak type (P<0.05). For the distance of AB, AC, AD and the angle of ∠A, ∠ACF (Coronal plane), there were statistical differences between Hill type and Mountain peak type (P<0.05). For the distance of AD and the angle of ∠A, there were statistical differences between Hill type and Chimney type (P<0.05).　Conclusion　Under the CT three-dimensional reconstruction, the superior scapulae is classified into three types: Hilly type, Mountain peak type and Chimney type. Different types of superior scapulae may have a potential effect in neck pain and the levator muscle syndrome.