正常中国成人股骨颈α角的CT测量及股骨头颈交界处形态分型  

Assessment of the α-angle of femoral neck and morphological classification of the anterior femoral head-neck junction on CT-based images in normal Chinese adults

作　　者：程晓光[1] 过哲[1] 张晶[1] 王予生[1] 赵海竹[1] 王盟盟[1] 

机构地区：[1]北京积水潭医院放射科,100035

出　　处：《中华放射学杂志》2010年第11期1126-1130,共5页Chinese Journal of Radiology

基　　金：北京市卫生系统高层次卫生技术人才培养项目（2009-2-03）

摘　　要：目的 应用CT图像,测量中国成人股骨颈α角的正常值范围,并对股骨头颈交界处形态的分型进行初步探讨.方法 对652例因非股骨近端病变、无髋关节撞击综合征症状而接受下腹或双髋CT扫描的成年患者的CT体积数据进行后处理.双侧股骨近端均进行股骨颈α角的被测量者459例;因为一侧股骨近端病变而仅测量健侧股骨颈α角者193例,其中仅进行左侧股骨颈α角的被测量者93例,仅进行右侧股骨颈α角的被测量者100例.共重组出1111组沿股骨颈长轴的股骨近端斜矢状图像,选取经过股骨颈中间层面的图像,利用AutoCAD2006软件测量股骨颈α角,同时对股骨头颈交界处形态进行分型,并对测量的结果数据进行t检验或方差分析.结果 1111个股骨颈α角的平均值为38.2°±5.3°,正常值范围为28°～49°;其中左侧股骨近端552个,股骨颈α角为38.0°±5.3°;右侧股骨近端559个,股骨颈α角为38.4°±5.3°;双侧股骨颈α角的差异无统计学意义（t=-1.231,P＞0.05）.男性股骨近端654个,股骨颈α角为39.2°±5.8°,女性股骨近端457个,股骨颈α角为36.8°±4.1°,股骨颈α角的性别差异有统计学意义（t=-8.180,P＜0.01）.各年龄段之间股骨颈α角的差异无统计学意义（F=1.765,P＞0.05）.根据股骨头颈交界处前方形态将正常股骨头颈交界处分为3种类型,凹陷型（Ⅰ型）股骨头颈交界处明显凹陷,有168个,占15.1%,平均α角为31.2°±2.0°;光滑型（Ⅱ型）股骨头颈交界处皮质呈光滑的弧线与股骨头皮质相延续,有726个,占65.4%,平均α角为37.4°±2.4°;平坦型（Ⅲ型）股骨头颈交界处皮质平坦呈直线状,有217个,占19.5%,平均α角为46.4°±3.8°;3组股骨颈α角之间的差异有统计学意义（F=1636.107,P＜0.01）,3组股骨颈α角两两比较组间差异均有统计学意义（P＜0.01）.结论 根据股骨头颈交界处形态将正常股骨头颈交界处分为凹陷型、光滑型及平坦型可以�Objective To investigate the normal range of the femoral neck α-angle in normal Chinese adults and classify the morphology of the anterior femoral head-neck junction on CT-based images. Methods Six hundred and fifty-two adult patients （Bilateral： 459 patients, unilateral：193 patients） with the total of 1111 hips （552 left; 559 right, and 654 male; 457 female） without known diseases affecting the proximal femur or symptoms of femoroacetabular impingement （FAI） underwent 64-slice CT scanning for medical purpose with the hip included in the scan range. The volume CT data was used for further analysis in this study. Oblique sagittal plane images paralleling to the axis of the femoral neck were reconstructed with the volume CT data, the image through the middle of the femoral neck was chosen to measure α-angle with AutoCAD2006 software. The morphology of the anterior femoral head-neck junction was classified. Analysis of variance and t-test were performed with SPSS 15.0. Results The mean value of α-angle of all 1111 hips was 38. 2° ±5.3°. The normal range of α-angle in Chinese adults was 28°to 49°.The mean value of left and right α-angles were 38. 0° ±5. 3°and 38.4° ±5. 3° ,respectively, and there was no statistically significant difference between both sides （t = - 1. 231 ,P ＞ 0. 05 ）. Males have greater α-angles than females 39. 2° ±5. 8 vs 36. 8° ±4. 1°, with t = -8. 180, P ＜0. 01. There was no statistically significant differences of the α-angles of the seven age groups （F = 1. 765, P ＞ 0. 05 ）. In all 1111 proximal femora, 168 were classified as concave type, accounting for 15. 1%, with a mean α-angle of 31.2° ±2. 0°,726 were smooth type, accounting for 65.4%, with a mean α-angle of 37.4° ± 2. 4°, and 217 were flat type, accounting for 19.5%, with a mean α-angle of 46. 4° ±3. 8°. The differences of the α-angles of the three groups reached statistical significance （ F = 1636. 107, P ＜ 0. 01 ）. Conclusions The morphology of anterior femoral hea

关 键 词：股骨颈 股骨头 体层摄影术 X线计算机 人体测量术 

分 类 号：R686[医药卫生—骨科学]