肘部脂肪垫量化方法选择及正常参考值预测  

Methods of Quantifying the Elbow Fat Pad and the Prediction of Normal Reference Value

作　　者：石思李[1] 李胜[1] 邹文远[1] 张秋南 杨茜茜[1] 陈玉峰[1] 侯明伟[1] 

机构地区：[1]湖北医药学院附属人民医院放射科,湖北十堰442000

出　　处：《湖北医药学院学报》2015年第1期58-62,共5页Journal of Hubei University of Medicine

摘　　要：目的：探讨＂厚度＂和＂角度＂两种方法量化肘部脂肪垫的可行性,择优评估正常人群肘部脂肪垫的参考值,为今后量化脂肪垫提供参考资料。方法：回顾性观察269例正常人群肘部脂肪垫的X线表现,由两名医师分别采用＂厚度＂和＂角度＂法量化正常脂肪垫,并对测量结果的可靠性进行信度比较,分析其影响因素;选择可靠性更高的方法,将正常人群按年龄和性别分组后,对肘部脂肪垫进行量化评估,并对各组数据进行统计分析。结果：269例中182例可测量脂肪垫厚度和角度。两名医师厚度测量法结果变异系数（CV）分别为22.67%和21.14%;角度测量法CV分别为29.54%和30.21%。影响脂肪垫量化的主要因素是正常人群肱骨干生理弯曲。厚度法量化结果显示,AFP厚度值未成年人与成年人间有差异（P〈0.05）,性别间无差异（P〉0.05）。成年人和未成年人肘关节脂肪垫95%CI分别为（1.76-4.50）mm和（2.03-4.81）mm。结论：肱骨干生理性弯曲是影响角度测量法准确性的最主要因素,不同人员厚度测量法可靠性高于角度法。未成年人和成年人AFP正常厚度值存在差异,性别间无差异。了解正常肘关节脂肪垫的参考值,有助于评估肘关节外伤患者的病情。Objective To evaluate the feasibility of quantifying the elbow fat pad by two kinds of methods, ＂ thickness＂ method and ＂ angle＂ method,then select the better one to estimate the normal reference value of elbow fat pad,in order to provide reference to quantify fat pad in the future. Methods The X-ray manifestation of 269 cases of healthy samples were retrospectively analyzed,and the normal elbow fat pad was quantified with two physicians by both thickness method and angle method,respectively. The reliability of quantified results was compared by the coefficients of variation（ CV）,and the possible influencing factor was analyzed. The more reliable method was selected from the above two,and used for the quantification of elbow fat pad during different subgroups that divided according to age and gender,the data of every subgroup was statistically analyzed finally. Results Among 269 cases of healthy samples,the thickness or angle of elbow fat pad could be measured in 182 cases. The CV of thickness method measured by two physicians was 22. 67% and 21. 14%,respectively.The CV of angle method measured by two physicians was 29. 54% and 30. 21%,respectively. The physiogenic flexion of humeral shaft was the major factor affecting the measurement. The results measured by using thickness method demonstrated that the value of anterior fat pad（ AFP） did not show the difference between male and female（ P〉 0. 05）,but between minor and adult（ P〈 0. 05）. The 95% CI of fat pad thickness in minor and adult was（ 1. 76 - 4. 50） mm,（ 2. 03 - 4. 81） mm,respectively. Conclusion The physiogenic flexion of humeral shaft was the major factor affecting the accuracy of the angle method,the thickness method has higher reliability than the angle method when evaluating the elbow fat pad. The normal thickness of AFP did not show the difference between male and female,but between minor and adult. The evaluation of normal reference value may be helpful for clinical diagnosis of patients with elbow joint trauma.

关 键 词：脂肪垫 肘关节 X线摄影术 

分 类 号：R816.8[医药卫生—放射医学]