成人桡骨近端形态学对称性的三维偏差分析  

An anatomical symmetry study of proximal radii in adults using three-dimensional deviation analysis

作　　者：孔勇杰 黄涛[2] 王勉[2] 谭晋川 杨洋[2] 黄文华[2] KONG Yongjie;HUANG Tao;WANG Mian;TAN Jinchuan;YANG Yang;HUANG Wenhua(Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Guangdong Engineering Research Center for Translation of Medical 3D Printing Application,Guangdong Provincial Key Laboratory of Medical Biomechanics,National Key Discipline of Human Anatomy,School of Basic Medical Science,Southern Medical University,Guangzhou 510515,China;The Fourth District of Orthopedics,Panyu Hospital of Chinese Medicine,Guangzhou 511400,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]南方医科大学基础医学院人体解剖学国家重点学科,广东省医学生物力学重点实验室,广东省医学3D打印应用转化工程技术研究中心,广东广州510515 [3]广州市番禺区中医院骨科四区,广东广州511400

出　　处：《中国医学物理学杂志》2020年第9期1124-1129,共6页Chinese Journal of Medical Physics

基　　金：国家重点研发计划(2017YFC1103400);广东省自然科学基金面上项目(2020A151501998);广东省科技计划(2016B090917001,2017B090912006);深圳市医疗卫生“三名工程”高层次医学团队(SZSM201612019);佛山市深入推进创新驱动助力工程(2019012)。

摘　　要：目的:利用测量三维形态的方法量化验证成人双侧近端桡骨的解剖形态学对称性。方法:提取15名正常志愿者的CT平扫来三维重建桡骨近端的解剖结构,并且测量两侧桡骨模型的表面积和体积;然后使用三维偏差分析法可视化和定量化地分析两侧桡骨近端模型的解剖对称性。结果:两侧桡骨近端体积的平均百分比差异为4.43%±3.90%(P=0.595),表面积的平均百分比差异为2.79%±2.41%(P=0.321)。偏差结果中,最大负偏差的均值±标准差为(-1.14±0.41)mm,最大正偏差的均值±标准差为(1.00±0.37)mm;桡骨近端的非关节面部分是主要的偏差分布区域。结论:成人双侧桡骨近端具有满足临床需求的解剖对称性,这为采用健侧桡骨近端形态指导解剖重建治疗桡骨近端骨折提供了可靠依据。在涉及桡骨近端关节面重建的复杂骨折治疗,开展计算机辅助与三维打印技术结合的术前规划将有效增加患者的获益。Objective To quantitatively analyze the anatomical symmetry of bilateral proximal radii in adults based on threedimensional morphological measurement.Methods The anatomical data of the left and right proximal radii for threedimensional reconstruction were extracted from computed tomography scans of 15 normal individuals.After that both bone volume and surface area of the left and right proximal radii models were measured,the anatomical symmetry between the right and left proximal radii were quantified and visualized using three-dimensional deviation analysis.Results The mean percentage difference in bone volume between the left and right proximal radii was 4.43%±3.90%(P=0.595),and that in surface area was 2.79%±2.41%(P=0.321).The results of the three-dimensional deviation analysis showed that the mean±standard deviation of the maximal negative deviation was(-1.14±0.41)mm,while that of the maximal positive deviation was(1.00±0.37)mm.Moreover,the relatively high deviations were mainly distributed in those regions which were away from the joint facets.Conclusion The bilateral proximal radii in adults show an excellent anatomical symmetry,which satisfies the clinical requirements and provides a reliable basis for proximal radial fracture reduction guided by the morphological model of the contralateral proximal radius.In the treatment of complex fractures involving the articular surface of proximal radii,the preoperative planning that combines computer-aided and three-dimensional printing technologies will effectively increase the benefits for the patients.

关 键 词：桡骨近端 三维偏差分析 解剖学 形态学 

分 类 号：R318[医药卫生—生物医学工程] R319[医药卫生—基础医学]