CAJ | 학술논문

目的探讨成人骨性后颅凹(PCF)狭窄的MSCT诊断标准与临床意义.方法采用MSCT及MPR、VR图像后处理技术,测量100名(男、女各50名)正常成人(对照组)和经MSCT检查及临床、手术证实的52例枕大孔区骨畸形患者(异常组)的PCF容积(PCFV)、PCF高径(PCFH)、斜坡长度(CL)、斜坡倾斜角(CG)、枕骨鳞部长度(SL)、枕大孔前后径(FMD),对其间的相关性和临床意义进行回顾性分析.对测量数据进行t检验.结果 PCFV、PCFH、CL、SL、FMD、CG测量结果,对照组男性分别为(168.2±12.3)cm~3、(38.2±1.2)、(47.1±2.8)、(41.1±1.8)、(36.6±4.9)mm、(51.5±3.6)°,女性分别为(157.5±10.2)cm~3、(36.5±1.4)、(46.2±2.2)、(39.7±1.3)、(35.2 ±3.8)mm、(49.6±3.1)°;异常组分别为(128.7 ±11.7)cm~3、(30.6±1.9)、(36.2 ±1.4)、(37.3 ±0.9)、(33.9 ±3.5)mm、(44.5±2.8)°.对照组内不同性别之间PCFV、PCFH、CL、SL、CG差异有统计学意义(t值分别为4.70、6.44、4.84、4.43、2.81,P值均<0.01),各组间FMD差异无统计学意义(t=1.97,P>0.05);对照组男性与异常组PCFV、PCFH、CL、SL、CG差异有统计学意义(t值分别为16.62、24.04、25.01、14.17、10.99,P值均<0.01);对照组女性与异常组PCFV、PCFH、CL、SL、CG差异有统计学意义(t值分别为13.23、17.80、27.50、11.67、8.73,P值均<0.01);对照组男、女FMD与异常组比较差异无统计学意义(t值分别为2.96、2.07,P值均>0.05).结论 MSCT可对PCF进行定量测量,作为术前常规检查有助于选择恰当的手术方式和PCF的应用解剖及其病理特征的研究.
목적 탐토성인골성후로요(PCF)협착적MSCT진단표준여림상의의.방법 채용MSCT급MPR、VR도상후처리기술,측량100명(남、녀각50명)정상성인(대조조)화경MSCT검사급림상、수술증실적52례침대공구골기형환자(이상조)적PCF용적(PCFV)、PCF고경(PCFH)、사파장도(CL)、사파경사각(CG)、침골린부장도(SL)、침대공전후경(FMD),대기간적상관성화림상의의진행회고성분석.대측량수거진행t검험.결과 PCFV、PCFH、CL、SL、FMD、CG측량결과,대조조남성분별위(168.2±12.3)cm~3、(38.2±1.2)、(47.1±2.8)、(41.1±1.8)、(36.6±4.9)mm、(51.5±3.6)°,녀성분별위(157.5±10.2)cm~3、(36.5±1.4)、(46.2±2.2)、(39.7±1.3)、(35.2 ±3.8)mm、(49.6±3.1)°;이상조분별위(128.7 ±11.7)cm~3、(30.6±1.9)、(36.2 ±1.4)、(37.3 ±0.9)、(33.9 ±3.5)mm、(44.5±2.8)°.대조조내불동성별지간PCFV、PCFH、CL、SL、CG차이유통계학의의(t치분별위4.70、6.44、4.84、4.43、2.81,P치균<0.01),각조간FMD차이무통계학의의(t=1.97,P>0.05);대조조남성여이상조PCFV、PCFH、CL、SL、CG차이유통계학의의(t치분별위16.62、24.04、25.01、14.17、10.99,P치균<0.01);대조조녀성여이상조PCFV、PCFH、CL、SL、CG차이유통계학의의(t치분별위13.23、17.80、27.50、11.67、8.73,P치균<0.01);대조조남、녀FMD여이상조비교차이무통계학의의(t치분별위2.96、2.07,P치균>0.05).결론 MSCT가대PCF진행정량측량,작위술전상규검사유조우선택흡당적수술방식화PCF적응용해부급기병리특정적연구.
Objective To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults.Methods MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed.Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR).The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and anteroposterior diameter of the foramen magnum (FMD) were measured on sagittal images in 52 patients and 100 normal adults.Independent-sample student's t test was used to compare the differences between patients and normal adults.Results The results of PCFV, PCFH, CL, SL,FMD and CG, male of control group were (168.2 ±12.3) cm~3, (38.2 ±1.2), (47.1 ±2.8), (41.1 ±1.8), (36.6 ±4.9) mm, (51.5±3.6)°, female of control group were (157.5 ±10.2) cm~3, (36.5 ±1.4), (46.2 ±2.2), (39.7 ±1.3), (35.2 ±3.8), (49.6±3.1)° ;diseased group were (128.7 ±11.7) cm~3, (30.6 ±1.9), (36.2 ±1.4), (37.3 ±0.9), (33.9 ±3.5)mm, (44.5 ±2.8)° .There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t =4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant(t=1.97,P>0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively,P<0.01) ; the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively,P<0.01) ;but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96,2.07, P> 0.05).Conclusions The overcrowding of PCF can be accurately measured by MCST.As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF.