儿童及青少年枕颈角与后枕颈角数字化测量及其临床意义  

Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents

作　　者：李琨 张燕 郭冉 郝咪咪 吴轩宇 徐艺芳 王超群 马文童 张灵淇 杨宏宇 李志军 张少杰 王星 Li Kun;Zhang Yan;Guo Ran;Hao Mimi;Wu Xuanyu;Xu Yifang;Wang Chaoqun;Ma Wentong;ZhangLingqi;Yang Hongyu;Li Zhijun;Zhang Shaojie;Wang Xing(Department of Human Anatomy,College of Basic Medical Sciences,Inner Mongolia Medical University(Digital Medical Center),Hohhot 010110,China;Ordos Clinical Medical College,Inner Mongolia Medical University,Ordos 017001,China;Imaging Center,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010110,China)

机构地区：[1]内蒙古医科大学基础医学院人体解剖学教研室(数字医学中心),呼和浩特010110 [2]内蒙古医科大学鄂尔多斯临床医学院,鄂尔多斯017001 [3]内蒙古医科大学附属医院影像中心,呼和浩特010110

出　　处：《中国临床解剖学杂志》2024年第1期17-20,25,共5页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金资助项目(81860383,81860382);内蒙古自治区自然科学基金项目(2020LH08021,2022QN03002,2020MS03061);内蒙古医科大学青年基金项目(YKD2020QNCX055);内蒙古医科大学英才培育项目(YCPY2022019,YCPY2022051);内蒙古医科大学大学生创新创业项目(202110132025,202210132031,202210132011);内蒙古医科大学科研重点项目(YKD2021ZD011,YKD202ZD007);内蒙古自治区高等学校青年科技英才支持计划资助(NJYT22009);内蒙古自治区科技计划项目(2019GG158);内蒙古自治区卫生健康委医疗卫生科技计划项目(202201217)。

摘　　要：目的通过对儿童及青少年枕颈角(occipito-C_(2)angle,OC_(2)A)和后枕颈角(posterior occipitocervical angle,POCA)的影像学测量,研究其随年龄增长的变化规律及性别差异,为临床枕颈融合术提供理论依据。方法回顾性筛选符合排纳标准的正常儿童及青少年321例(男213例,女108例)颅颈结合区的影像学资料,按性别、年龄分为1~3岁、4~6岁、7~9岁、10~12岁、13~15岁和16~18岁等6组。将扫描的颈椎断层影像原始数据以DICOM格式存贮,并导入Mimics 16.0观测其OC_(2)A和POCA。结果OC_(2)A和POCA的峰值分别为(18.15±5.63)°和(124.94±14.63)°,位于10~12岁组,随后呈波浪状下降,OC_(2)A在10~12岁组与1~3岁组、13~15岁组与10~12岁组间存在显著性差异(P<0.05);POCA在7~9岁组与10~12岁组、13~15岁组和16~18岁组间存在显著性差异(P<0.05);男女比较,OC_(2)A和POCA均无性别差异(P>0.05);经过相关性分析,OC_(2)A和POCA之间存在负相关性(r=-0.28,P=0.000)。结论临床枕颈融合术中仅需考虑年龄差异,而不必考虑性别差异;本研究亦可为后路枕颈融合术OC_(2)A与POCA的角度选择提供理论依据。Objective To study the changes of occipitocervical Angle(OC_(2)A)and posterior occipitocervical Angle(POCA)in children and adolescents with age and gender,so as to provide theoretical basis for the clinical treatment of occipitocervical fusion.Methods The imaging data of 321 cases(213 males and 108 females)were retrospectively studied and divided into 6 groups according to sex and age,including 1~3 year-old group,4~6 year-old group,7~9 year-old group,10~12 year-old group,13~15 year-old group and 16~18 year-old group.The original cervical tomography data were stored in DICOM format and imported into Mimics 16.0 to analyze the OC_(2)A and POCA.Results By analyzing OC_(2)A and POCA in different age groups,it was found that the peak values of OC_(2)A and POCA were(18.15±5.63)°and(124.94±14.63)°,respectively in the 10-12 year-old group,and then showed a wavy downward trend.There were significant differences in OC_(2)A between 10-12 year-old and 1-3 year-old and between 13-15 year-old and 10-12 year-old(P<0.05).There were significant differences in POCA between the 7-9 year-old group and the 10-12 year old group,the 13-15 year old group and the 16~18 year old group(P<0.05).There was no gender difference in OC_(2)A and POCA between males and females(P>0.05).In correlation analysis,there was a negative correlation between OC_(2)A and POCA(r=-0.28,P=0.000).Conclusions In the clinical treatment of occipitocervical fusion,only age differences can be considered,without considering gender differences.This study,through the systematic study of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents,also provides theoretical basis for the Angle selection of OC_(2)A and POCA in posterior occipitocervical fusion.

关 键 词：枕颈角 后枕颈角 相关性 枕颈融合术 儿童 青少年 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]