基于三维骨折地图技术的腰椎节段动脉特征研究  

Study on the characteristics of lumbar segmental arteries based on three-dimensional fracture map technology

作　　者：赵一帆 靳江涛 郭小波 刘君阳 ZHAO Yifan;JIN Jiangtao;GUO Xiaobo;LIU Junyang(The First Clinical School of Changzhi Medical College,Changzhi 046000,China;Department of Minimally Invasive Spine Orthopedics,Jincheng General Hospital,Jincheng 048000,China)

机构地区：[1]长治医学院第一临床学院,046000 [2]晋城大医院脊柱微创骨科,048000

出　　处：《国际骨科学杂志》2025年第1期44-51,共8页International Journal of Orthopaedics

基　　金：山西省卫生健康委员会“四个一批”科技兴医创新计划(2021XM39)

摘　　要：目的应用骨折地图技术分析腰椎节段动脉走行及分布特征,并讨论其临床意义。方法回顾性分析108例患者L_(1)~L_(5)水平增强CT影像资料。选取1位35岁健康男性志愿者的增强CT数据,三维重建L_(1)~L_(5)椎体模型,作为腰椎节段走行线绘制模板。应用3D-Slicer 5.2.2软件重建108例患者的L_(1)~L_(5)椎体及腰椎节段模型,再将模型导入E-3D medical 20.52软件,使其与标准模板拟合,在标准模型上绘制腰椎节段动脉走行线,创建腰椎节段动脉线图和热图。计算腰椎节段动脉存在率,测量平面Ⅰ、平面Ⅱ两侧腰椎节段动脉相对高度。结果①腰椎节段动脉线图可见明显汇集带。前视图见L_(1)~L_(4)节段动脉整体偏左,L_(1)~L_(3)节段动脉起自椎体前下方,L_(4)节段动脉起自上半椎体,L_(5)节段动脉走行线稀疏,路径多变。左、右视图特征相似,但左侧汇集带较分散,L_(1)~L_(3)节段动脉呈“拱形”分布,L_(4)节段动脉呈“下斜形”分布,L_(5)节段动脉呈稀疏性“下斜形”分布。②热图对腰椎节段动脉特征呈现更佳。左、右侧视图中,L_(1)~L_(4)红色条带与椎体前缘的夹角逐渐增大,且在后半椎体向尾端的倾斜度逐渐增大,同时其在椎间孔处的位置逐渐降低;此外,左侧彩色条带分布范围较右侧大。③L_(1)~L_(4)节段动脉存在率分别为99%、100%、100%和95%(左、右侧相同),L_(5)节段动脉存在率为9.3%(左侧)和10.2%(右侧)。④同平面同侧腰椎节段动脉相对高度在L_(1)~L_(5)节段存在差异(P<0.05)。两两比较,除平面Ⅰ左侧L_(1)与L_(2)节段无统计学差异(P>0.05)外,平面Ⅰ左侧其他节段间、平面Ⅰ右侧各节段间、平面Ⅱ左侧各节段间、平面Ⅱ右侧各节段间比较均有统计学差异(P<0.05)。在平面Ⅰ,除L_(2)外,L_(1)~L_(4)节段动脉平均相对高度逐渐增高;在平面Ⅱ,L_(1)~L_(4)节段动脉平均相对高度逐渐降低。⑤同平面左右侧腰椎节段动脉相对高�Objective To employ fracture mapping technology to investigate the trajectory and distribution characteristics of lumbar segmental arteries,thereby improving physicians'comprehension of these arteries'features and evaluating their clinical significance.Methods Retrospective analysis of enhanced CT imaging data from 108 patients at the L_(1)–L_(5) levels.Enhanced CT data were selected from a 35-year-old healthy male and a three-dimensionalreconstruction model of vertebrae L_(1)–L_(5) was created,which served as a template for mapping the segmental artery trajectories.Then,3D Slicer 5.2.2 software was employed to reconstruct the L_(1)–L_(5) vertebral and segmental artery models from 108 patients,and subsequently these models were imported into E-3D medical 20.52 software for alignment with a standard template.The segmental artery trajectory lines were drawn on the standard model and segmental artery line diagrams and heatmaps were generated.The prevalence of lumbar segmental arteries was then evaluated and their relative heights on both sides were measured at Planes I and II.Results①The segmental artery line diagrams revealed distinct convergence zones.In the anterior view:L_(1) to L_(4) werepredominantly left-sided overall;L_(1)–L_(3) originated from the anteroinferior aspect of the vertebral body,while L_(4) originated from the upper half of the vertebral body;the trajectory of L_(5) was sparse and variable.The features in the left and right views weresimilar,but the convergence zone on the left side wasmore dispersed:L_(1)–L_(3) displayed an“arch-shaped”distribution,while L_(4) exhibited a“downward-sloping”distribution,and L_(5) showeda sparse“downward-sloping”distribution.②The heatmap provideda superior depiction of segmental artery characteristics.In the left and right lateral views,the angle between the red lineand the anterior margin of the vertebral body gradually increased from L_(1) to L_(4),along with a progressive increase in the inclination of the posterior half of the vertebr

关 键 词：腰椎节段动脉 骨折地图 热图 三维重建 

分 类 号：R68[医药卫生—骨科学]