基于CT和MRI三维重建前交叉韧带股骨止点的解剖学研究  

An anatomic study on the femoral attachment of anterior cruciate ligament by combined CT and MRI three-dimensional reconstruction

作　　者：张冰[1] 李光磊[2] 王宝鹏[2] 路世勇[2] 

机构地区：[1]滨州医学院,山东滨州256603 [2]滨州医学院附属临淄区人民医院骨一科,山东淄博255400

出　　处：《中国矫形外科杂志》2015年第8期738-742,共5页Orthopedic Journal of China

摘　　要：[目的]通过CT及MRI扫描重建正常人群膝关节ACL股骨止点,为解剖重建ACL准确定位股骨止点提供临床解剖学数据。[方法]对46名志愿者双侧共92个膝关节进行CT及MRI扫描,测量ACL股骨附着点的面积、形态以及与周围结构的关系。并进行性别间比较。[结果]男性ACL股骨止点面积(103.6±13.0)mm2显著大于女性(86.5±11.6)mm2(t=6.637,P=0.000);后距(4.1±1.7)mm长于女性(2.9±1.2)mm(t=3.992,P=0.000);远距(5.4±1.3)mm长于女性(4.0±1.3)mm(t=5.338,P=0.000);内距(2.3±1.3)mm与女性(2.3±1.3)mm比较差异无统计学意义(t=-0.330,P=0.742)。男性ACL长轴角(13.3±5.8)°与女性(10.9±6.3)°比较差异无统计学意义(t=1.867,P=0.065)。[结论]ACL股骨止点有多种形态,股骨止点面积有性别差异,重建ACL应结合股骨止点的形态、位置、大小、性别等特点进行个体化重建。[Objective]To study the femoral insertionof anterior cruciate ligament（ACL） by combined CT and MRI three-dimensional reconstruction,so that to provide anatomic reference for ACL reconstruction.[Method]Ninety-two knees from the both knees of 46 volunteers were scanned with CT and MRI.Combined CT and MRI three-dimensional imaging of the knee were reconstructed,subsequently,the dimension of the femoral insertion of ACL,and its relationship to surrounding structures were measured using Mimics and Geomagic software.The data was statistically analyzed with SPSS 17.0 software.[Result]The area of ACL femoral attachment was 103.6 ± 13.0 mm2 in male and 86.5 ± 11.6 mm2 in female respectively.The long axis was15.3 ± 1.7 mm in male and 14.3 ± 2.1 mm in female,and the short axis was 8.5 ± 1.8mm in male and 5.5 ± 1.9 mm in female.In addition,the shortest distance to the posterior margin of the femur was 4.1 ± 1.7 mm in male and 2.9 ± 1.2 mm in female,and the shortest distance to the distal margin of the femur was 5.4 ± 1.3 mm in male and 4.0 ± 1.3 mm in female.There were significantly statistical differences between male and female in above-mentioned parameters（P〈0.05）.However,there were no significantly statistical differences between the two genders in the shortest distance to the internal margin of the femur（2.3 ± 1.3 in male and 2.3 ± 1.3 mm in female）,and the angle between axis of the attachment and the longitudinal axis of the femur（13.3 ± 5.8° in male and10.9 ± 6.3° in female）（P〉0.05）.[Conclusion]There is significant variation in the shape and dimension of the ACL femoral insertion among these health volunteers,associated with remarkable difference in area of the insertion between the two genders.It implies that morphology,location and sizes of the ACL,even sex of the patients should be taken into account for individualized reconstruction of ACL.

关 键 词：前交叉韧带 股骨止点 CT MRI 解剖学 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]