CT三维重建测量胸骨角对应胸椎平面150例结果分析  

Analysis of 150 cases from measuring sternal angle corresponded to thoracic plane by three-dimensional reconstruction of spiral CT

作　　者：周兴宁[1,2] 姚骊 李相位 吕粟[1] 

机构地区：[1]四川大学华西医院放射科,四川成都610041 [2]西藏自治区人民政府驻成都办事处医院放射科,四川成都610041

出　　处：《局解手术学杂志》2016年第3期175-178,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金面上项目(81371527)

摘　　要：目的通过CT三维重建方式进行胸骨角对应胸椎位置的测量,探索颈胸交界区病变的准确定位方法及术前评估。方法选择经双能X射线骨密度仪确诊骨量正常42例,骨量减少48例,骨质疏松60例,利用16排螺旋CT胸部容积扫描三维重建方法,进行胸骨角对应胸椎位置的测量及胸椎后凸角测量。结果胸骨角对应胸椎范围为测量单元Ⅲ~Ⅵ,以测量单元Ⅳ为主,约占55%。胸骨角对应胸椎位置与骨量统计结果无相关性,两者的关系有待进一步研究。胸骨角对应胸椎位置与胸椎后凸角具有相关性,胸椎后凸角越大,对应位置越低。结论胸骨角对应胸椎节段并非恒定、准确的平面,不宜作为胸椎节段的准确定位标志。胸骨角对应胸椎位置的测量及与胸椎后凸角的相关关系的评价,对于颈胸交界区病变准确定位及手术治疗的术式、路径选择、胸骨柄的处理方式等内容的预评估具有重要临床意义。Objective To measure the sternal angle corresponded to thoracic plane by three-dimensional reconstruction of spiral CT,and to explore the accurate positioning methods and the preoperative assessment of cervicothoracic junction lesions. Methods Selected 42 cases of normal bone mass,48 cases with bone loss,and 60 cases of osteoporosis who were diagnosed by dual-energy X-ray absorptiometry,and measured the location of thoracic sternal angle corresponded to the thoracic spine and thoracic kyphosis angle through the volume reconstruction data of the 16-slice spiral CT chest examinations. Results The range of sternal angle corresponded to thoracic plane was measurement units Ⅲ to Ⅵ. The measure unit Ⅳ was the most,accounting for about 55%. There was no statistical significance between the position of sternal angle corresponded to thoracic plane and the relationship of bone mass,which required further study. The position of sternal angle corresponded to thoracic plane was associated with the thoracic kyphosis angle. The larger the thoracic kyphosis angle,the lower the corresponding position was. Conclusion The thoracic segment corresponded to the sternal angle is not a constant or accurate plane,which is not properly concerned as an accurate positioning mark to the thoracic segment. The measurement of the thoracic sternal angle was corresponded to the thoracic spine location,and its co-relationship evaluation between the thoracic kyphosis angle was vital for the accurately positioning of cervico-thoracic junction area lesions,the pre-assessment methods of surgical treatment,approach selection,and different methods for sternum and other such contents. This research was of important clinical significance.

关 键 词：胸骨角 胸椎 胸椎后凸角 颈胸交界区 脊柱颈胸段 电子计算机X射线断层扫描 

分 类 号：R681.5[医药卫生—骨科学]