数字化软件测量僵硬性马蹄内翻足相关骨标志性指标的可靠和准确度  

Reliability and accuracy of digital software in measuring osseous markers related to stiff clubfoot

作　　者：刘伟[1] 李飞[1] 李璐兵[1] 王雪[1] 王成伟[2] Liu Wei;Li Fei;Li Lubing;Wang Xue;Wang Chengwei(Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China;Third Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第六附属医院,新疆维吾尔自治区乌鲁木齐市830000 [2]新疆医科大学第三附属医院,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《中国组织工程研究》2022年第6期886-891,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81860164),项目负责人:王成伟。

摘　　要：背景:僵硬性马蹄内翻足是复杂的三维异常结构畸形,应用二维平片以及体格检查等难以对僵硬性马蹄内翻足畸形程度进行精准评估。目的:探讨数字化软件测量僵硬性马蹄内翻足相关指标的可靠性和准确性。方法:前瞻性选择2018年2月至2021年3月在新疆医科大学第六附属医院就诊的14例(20足)僵硬性马蹄内翻足患者,应用mimics软件根据负重位CT图像重建出负重状态下所需骨骼3D模型,运用3-Matic拟合出所需骨骼的中轴线,使用选择性投射功能获取负重正位、侧位及跟骨轴位图像,进行僵硬性马蹄内翻足相关指标测量。利用3-Matic软件测量法与常规X射线测量法对14例僵硬性马蹄内翻足患者进行相关指标测量,比较两组观察指标的统计学差异。研究已通过新疆医科大学伦理委员会审批,所有患者均签署知情同意书。结果与结论:(1)两种方法测量的结果:正位片距骨-跟骨角、距骨-第1跖骨角差异无显著性意义(P>0.05),跟骨-骰骨角差异有显著性意义(P<0.05);侧位片跟骨-距骨角、胫骨-跟骨角、距骨-第1跖骨角、跟骨-第5跖骨角差异无显著性意义(P>0.05);跟骨轴位片胫骨-跟骨角差异无显著性意义(P>0.05);(2)结果说明,应用3-Matic软件测量可以精准生成所需骨骼中轴线,进而实现相关指标的精确测量,测量时可以选择性投射相关骨骼及其中轴线,消除重影干扰,测量结果稳定可靠,观察时具有直观、清晰等优点。BACKGROUND:Stiff clubfoot is a complex three-dimensional abnormal structural deformity.It is difficult to accurately evaluate the deformity degree of stiff clubfoot by two-dimensional plain film and physical examination.OBJECTIVE:To explore the reliability and accuracy of 3-Matic software in measuring the related indexes of stiff clubfoot.METHODS:Totally 14 patients(20 feet)with stiff clubfoot were prospectively selected from February 2018 to March 2021 in the Sixth Affiliated Hospital of Xinjiang Medical University.The 3 D model of bone under weight-bearing condition was reconstructed by Mimics software according to the CT images of weight-bearing position.The central axis of the required bone was fitted by 3-Matic.The images of weight-bearing positive position,lateral position and calcaneal axial position were obtained by selective projection function.The related indexes of rigid equinovarus were measured.The related indexes of 14 adult patients with stiff clubfoot were measured by 3-Matic software measurement and routine X-ray measurement,and the statistical differences of the two groups were compared.This study was approved by the Ethics Committee of Xinjiang Medical University.All patients signed the informed consent.RESULTS AND CONCLUSION:(1)There was no significant difference between the positive talus-calcaneal angle and the talus-first metatarsal angle measured by the two methods(P>0.05),but there was significant difference between the calcaneal-cuboid angle measured by the two methods(P<0.05).There was no significant difference between the two methods in lateral calcaneal-talus angle,tibial-calcaneal angle,talus-first metatarsal angle,and calcaneal-fifth metatarsal angle(P>0.05).There was no significant difference in the axial tibial-calcaneal angle between the two methods(P>0.05).(2)It is concluded that the central axis of the required bone can be accurately generated by using 3-Matic software,and then the accurate measurement of related indexes can be realized.The related bone and its central axis can

关 键 词：马蹄内翻足 僵硬性 3-Matic软件 数字化 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学]