摘要
背景:下肢力线的测量结果经常受到多种因素的影响而出现偏差,不同体位下股骨侧弓角可影响下肢力线的测量。目的:通过CT扫描数据重建下肢骨骼模型,模拟下肢全长X射线检查,测量该模型在不同的旋转角度下的股骨侧弓角及股骨外翻角等数值,并探讨股骨侧弓对下肢力线测量的影响规律。方法:纳入进行下肢动脉CT血管造影的患者20例,Mimics 13.0软件对各病例CT扫描数据重建出该肢体骨骼的三维立体模型,确认其标准正位股骨侧弓角,分为4组:股骨侧弓角>2°组,股骨侧弓角大于0°,<2°组,股骨侧弓角>-2°小于0°组,股骨侧弓角<-2°组,每组5例。利用软件功能使其沿下肢纵轴以2°步幅精确旋转出自内旋20°至外旋20°的21个图像,由所得图像测量不同体位下的股骨侧弓角及股骨外翻角,以模拟下肢全长X射线检查下肢伴有旋转的情况。结果与结论:(1)股骨侧弓角的变化规律显示,下肢内旋使股骨侧弓角呈减小趋势,下肢外旋使股骨侧弓角加大趋势;(2)股骨外翻角随肢体外旋有逐渐增大的趋势,而随肢体内旋有逐渐减小的趋势;(3)各组不同体位下的股骨侧弓与股骨外翻角均呈显著正相关(P<0.01);(4)结果显示:采用CT扫描数据重建下肢骨骼模型模拟下肢全长X射线检查可见,股骨侧弓角测量结果会随肢体旋转发生变化,且会对股骨外翻角的测量结果产生影响,侧弓程度越大,由此产生的影响越大,所以拍摄下肢正位全长X射线片时应采用标准正位为投照体位,尤其对于股骨侧弓较大的病例。
BACKGROUND： Measuring result of the lower limb alignment is often influenced by various factors, such as femoral bowing angle （FBA） in different positions.OBJECTIVE： To measure the FBA and femoral valgus correction angle （VCA） in different positions after CT reconstruction of lower limb model, and simulating X-ray examination, and to explore the rule of FBA affecting lower limb alignment.METHODS： Twenty patients undergoing CT angiography of lower extremity artery were enrolled, three-dimensional reconstruction of low limb was established on Mimics13.0 software based on CT data, and the FBA in standard posture was determined. All patients were divided into groups A （FBA 〉 2°）, B （2° 〉 FBA 〉 0°）, C （0° 〉 FBA 〉 -2°） and D （FBA 〈-2°） （n=5 per group）. Then each model was revolved through the vertical axis from 20° of internal rotation to 20° of external rotation by 2° for one motion, and 21 three-dimensional images were transformed into two-dimensional images to obtain the X-ray images of low limb. FBA and VCA in different positions were measured.RESULTS AND CONCLUSION： （1） The outcome measurements showed that FBA tended to be decreased in internal rotation and increased in external rotation. （2） VCA tended to be increased in external rotation and decreased in internal rotation. （3） FBA was positively correlated with VCA in the different positions （P 〈 0.01）. （4） These results suggest that FBA can be altered with rotation and even expose influence on VCA. The bigger FBA is, the more influence on the lower limb alignment. Therefore, it is advisable to conduct the full length X-ray of lower limb in a standard posture, especially for the patients with larger FBA.
出处
《中国组织工程研究》
CAS
北大核心
2017年第11期1764-1769,共6页
Chinese Journal of Tissue Engineering Research
基金
首都卫生发展科研专项项目(2016-2-4062)~~
