基于股骨三维模型测量股骨前倾角的可行性分析  

Feasibility analysis of femoral anteversion angle measurement based on three-dimensional femoral model

作　　者：陈佳晖 马信龙[1] 马剑雄[1] 王颖[1] 柏豪豪 卢斌[1] 张士雄 Chen Jiahui;Ma Xinlong;Ma Jianxiong;Wang Ying;Bai Haohao;Lu Bin;Zhang Shixiong(Orthopaedic Institute,Tianjin Hospital,Tianjin 300021,China)

机构地区：[1]天津市天津医院骨科研究所,天津300021

出　　处：《中华骨科杂志》2024年第19期1288-1295,共8页Chinese Journal of Orthopaedics

基　　金：国家重点研发计划项目(2022YFC3601904)。

摘　　要：目的提出一种基于股骨三维模型测量股骨前倾角的方法。方法回顾性分析2019年1月至2023年12月于天津市天津医院门诊就诊的髌骨不稳定并接受双下肢全长CT检查的患者50例(100个股骨),男16例、女34例,年龄(28.5±11.9)岁(范围16~57岁)。所有患者均行双下肢CT检查,影像学资料以DICOM格式文件导入Mimics 21.0软件。通过阈值分割功能提取股骨,进行适当修整和光顺处理重建股骨三维模型。选择30例(60个股骨)患者的股骨三维模型导入3-matic 13.0软件进行解剖点的标记和轴线的绘制。股骨远端轴线选取股骨通髁轴线或后髁切线,股骨近端轴线采用股骨颈圆柱体拟合法或股骨头球体扩大法进行定义。股骨远端轴线与股骨近端轴线的夹角为股骨前倾角。两位观察者于股骨三维模型定位髁间窝顶点、大转子顶点、股骨头中心、股骨通髁轴和后髁切线标记点的空间坐标,比较组间差异。比较采用不同三维测量方法测得的股骨前倾角的差异并与临床报告的前倾角比较。结果两位观察者测量的30例(60个股骨)患者的股骨头中心和髁间窝顶点坐标数据的差异无统计学意义(P>0.05),而大转子顶点Y轴坐标数据分别为25.77±23.21和22.08±25.73,差异有统计学意义(t=2.906,P=0.017)。两位观察者测量的30例(60个股骨)患者的股骨通髁线和后髁切线坐标数据的差异无统计学意义(P>0.05)。以股骨机械轴作为投射方向,股骨通髁轴与后髁切线之间的夹角为5.97°±2.02°(范围1.48°~12.08°)。股骨颈圆柱体拟合法中两位观察者测得的股骨前倾角分别为23.35°±7.45°和24.94°±9.01°,差异有统计学意义(t=-2.147,P=0.040);股骨头球体扩大法中两位观察者测得的股骨前倾角为24.63°±7.66°和25.12°±8.84°,差异无统计学意义(t=-0.820,P=0.419)。采用股骨头球体扩大法定位股骨近端轴线,两位观察者按照上述方法测量50例(100股骨)患者的股骨�Objective To propose a method to measure the femoral anteversion angle based on the three-dimensional model of femur.Methods From January 2019 to December 2023,a total of 50 patients(100 femurs)with patellar instability who underwent full-length CT examination of both lower limbs in Tianjin Hospital were retrospectively analyzed,including 16 males and 34 females,aged 28.5±11.9 years(range,16-57 years).All patients underwent CT examination of both lower limbs,and the imaging data were imported into Mimics 21.0 software as DICOM format files.The femur was extracted by the threshold segmentation function,and the 3D model of the femur was reconstructed by appropriate trimming and smoothing.Three-dimensional models of the femur from 30 patients(60 femurs)were selected and imported into 3-matic 13.0 software for labeling of anatomical points and drawing of axes.The angle between the axis of the distal femur and the axis of the proximal femur was the femoral anteversion angle.Two observers positioned the spatial coordinates of the intercondylar fossa apex,the greater trochanter apex,the center of the femoral head,the femoral through-condylar axis and the posterior condylar tangent marker points on a 3D model of the femur to compare the differences between the groups.The femoral anteversion angles measured by different three-dimensional measurement methods were compared with the clinically reported femoral anteversion angles.ResultsThe difference between the femoral head center and intercondylar fossa apex coordinate data of 30 patients(60 femurs)measured by the two observers was not statistically significant(P>0.05),whereas the data for the Y-axis coordinate of the greater trochanter apex were 25.77±23.21 and 22.08±25.73,respectively,and the difference was statistically significant(t=2.906,P=0.017).The difference between the data of femoral through condylar and posterior condylar tangential coordinates of 30 patients(60 femurs)measured by the two observers was not statistically significant(P>0.05).Using the femoral m

关 键 词：股骨 骨前倾 成像 三维 

分 类 号：R681.8[医药卫生—骨科学]