摘要
目的通过双源CT(DSCT)三维重建前交叉韧带(ACL)股骨止点印迹及骨隧道面积,为临床实现解剖重建提供依据。方法分别对55例志愿者110膝,30例双束重建60膝及30例单束重建患者60膝进行DSCT扫描。64排工作站(GE,VolumeShare2-AW4.4软件)三维重建膝关节股骨外髁三维模型,再现股骨外髁内侧壁ACL印迹,圈画、测量印迹及骨隧道面积,计算单、双束骨道面积覆盖率。结果 ACL股骨自然印迹面积双膝之间:左(146.35±29.0)mm2,右(144.51±33.71)mm2,两者间无统计学差异(t=0.52,P>0.05)。性别间自然印迹面积比较:AMB:男(87.08±19.29)mm2,女(77.09±15.17)mm2,两者间有统计学差异(t=2.04,P<0.05);PLB:男(62.82±15.19)mm2,女(61.64±16.55)mm2,两者间无统计学差异(t=0.27,P>0.05)。术后隧道面积覆盖率比较:单束(53±18)%,双束(70±16)%,两者间有统计学差异(t=2.44,P<0.05)。结论 ACL股骨止点自然印迹面积存在性别间及个体化差异,双束重建止点面积覆盖率显著大于单束重建,要实现ACL解剖重建需采用个体化重建技术。
Objective To reconstruct the femoral footprint of anterior cruciate ligament（ACL） and measure the areas of femoral tunnels with dual-source computed tomography （DSCT） and three-dimensional （3D）technique, in order to establish a theory basis for the anatomic ACL reconstruction. Methods 110 knees from 55 volunteers were scanned by 64-slice spiral CT workstation （ GE, Volume Share2-AW 4. 4 version） ; 30 double-bundle reconstructed knees and 30 single-bundle reconstructed knees were examined under the same parameters. Lateral wall of the intercondylar notch and the ACL femoral footprint were reconstructed three-dimensionally. The area of original footprint and femoral tunnels was calculated and compared with that of single- and double-bundle femoral tunnel coverage. P-value 〈 0.05 was defined as significant. Results The mean area of ACL femoral footprint was （146. 35±29.0） mm2 in the left knee and （144. 51±33.71 ）mmz in the right knee respectively. There was no significant difference between the left and right （t = 0. 52, P 〉 0. 05）. Area of anterior-medial bundle （AMB） of male [ （87. 08±19. 29） mm2 ] was larger than that of female [ （ 77. 09±15. 17 ） mm2 ] （ t = 2. 04, P 〈 0. 05 ）, while there was no significant difference between male [ （62. 82±15.19） mm^2 ] and female [ （61.64 ±16. 55 ） mm^2 ] in areas of posterior-lateral bundle （PLB） （ t = 0. 27, P 〉 0. 05 ）. The footprint coverage was （53 ＋ 18 ） % in single-bundle reconstruction and （70±0. 16） % in double-bundle reconstruction; the later was significant higher than the former （t = 2.44, P 〈 0. 05 ）. Conclusions The natural ACL femoral footprints differs from one another in shape, position and area according to our observation by 3-D imaging reconstruction. Double-bundle reconstruction of ACL has better coverage of femoral anatomic insertion than single-bundle reconstruction. Individualized reconstruction should be applied in anatomic reconstruction of ACL.
出处
《中华关节外科杂志（电子版）》
CAS
2013年第1期17-20,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
陕西省社会发展基金(2010K130101)
关键词
前交叉韧带
股骨骨折
体层摄影术
X线计算机
Anterior eruciate ligament
Femoral fractures
Themography, X -Ray computed
