基于三维CT重建的寰椎椎弓根解剖学测量及临床意义

目的：研究螺旋CT三维重建测量人正常状态下寰椎椎弓根形态及其相关解剖学数据。方法：选取150例正常成人志愿者，年龄18—52岁（平均36．3岁），对其寰枢椎进行螺旋CT扫描，三维重建后观察椎弓根形态，并测量其双侧椎弓根各主要解剖数值：椎弓根高度、宽度、进钉点距后正中矢状面距离、椎根弓内倾角及上倾角。结果：根据椎弓根高度分为正常型；相对狭窄型；狭窄型；无椎弓根型。正常寰椎椎弓高度（4．10±1．17）mm，上倾角（8．24±1．31）°，内倾角（6．53±2．35）°，椎弓根宽度（8．24±1．31）mm，长度（28．73±1．66）mm，进钉点距后正中矢状面距离（19．36±1．27）mm。结论：三维CT重建能够全面观察寰椎影像解剖的立体结构，准确提供寰椎椎弓根的解剖学形态、解剖学参数，为寰椎椎弓根螺钉内固定技术提供解剖学依据。

Anatomic Measurement of Pedicles of Atlas and Axis by Three-dimensional Computer Tomography Reconstruction and Its Clinical Significance

Objective：To study the anatomic measurements and its homologic data of pedicies of atlas by 3D-CT reconstruction. Methods： 150 normal adults, aging from 18 to 52 years old （mean 36.3 years old）, were employed in this study. All patients＇ atlas pedicles were scanned by 3D-CT, shape of pedicles was observed after three-dimensional reconstruction, and the homologic anatomy data of both sides of pedicles were measured such as the height, width, length, inside oblique angles and upslope angles of pedicles as well as the distance from entry point of screw to the median sagittal plane. Results：According to the thickness of bone substance of vertebral artery sulcus, the anatomical morphology of atlas pedicles were classified into four types： general （61.3%）, relative stenosis（22%）, stenosis （10%） and none pedicles（6.7%）. The difference was not statistically significant. In normal, the height, width and length of pedicles is （4.10±1.17）mm, （8.24±1.31）mm and （28.73±1.66）mm respectively, the inside oblique angles and upslope angles is （6.53± 2.35）° and （8.24±.31）° respectively, and the distance from entry point of screw to the median sagittal plane is （19.36±1.27）mm. Conclusion：3D-CT reconstruction can overall observe the anatomical stereochemical structure of atlas and provide anatomic appearance and parameters of pedicles of atlas as well as the evidence for internal fixation with pedicle screw.