CAJ | 학술논문

目的：明确X线测量方法、MRI测量方法、解剖学测量方法三者的相互关系以及准确性和匹配性。方法选取意外死亡男性膝关节6只，年龄20～45岁，排除膝关节创伤和疾患，随机编号，分别行X线标准正侧位摄像、常规膝关节MRI扫描，将所得影像数据资料导入Unisight图象分析系统对相关指标进行测量并记录，然后将膝关节离断，直视下按照我院组织库的半月板测量方法进行测量并记录相关数据。X线测量指标包括：内侧胫骨平台矢状径、外侧胫骨平台矢状径、胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径。MRI测量指标包括：胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径、内外侧半月板的厚度(前角、体部、后角)、内外侧半月板的宽度(前角、体部、后角)。解剖学测量的指标包括：胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径、内外侧半月板的厚度(前角、体部、后角)、内外侧半月板的宽度(前角、体部、后角)。结果在半月板测量的直接指标中，除内侧半月板体部宽度、内侧半月板前角厚度、外侧半月板体部厚度的MRI测量变异系数＜10%之外，所有指标变异系数均＞10%。外侧半月板后角宽度及外侧半月板前角宽度的MRI测量，变异系数分别为65.97%、70.26%。半月板测量的间接指标，变异系数均＜10%。半月板厚度的MRI测量总大于解剖学测量结果。3种测量方法的一致性方面存在关联，但仍有差异。结论半月板相关测量指标中，X线测量值均偏大，经MRI测量的指标与解剖学测量结果接近，MRI所测的半月板指标较X线测量指标更具准确性及稳定性，值得推荐其作为临床匹配性测量的方法，其中胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径是稳定性最好的3个指标，变异系数均＜7%，且胫骨平台冠状径值得作为匹配性测量的首要指标。目的：明確X線測量方法、MRI測量方法、解剖學測量方法三者的相互關繫以及準確性和匹配性。方法選取意外死亡男性膝關節6隻，年齡20～45歲，排除膝關節創傷和疾患，隨機編號，分彆行X線標準正側位攝像、常規膝關節MRI掃描，將所得影像數據資料導入Unisight圖象分析繫統對相關指標進行測量併記錄，然後將膝關節離斷，直視下按照我院組織庫的半月闆測量方法進行測量併記錄相關數據。X線測量指標包括：內側脛骨平檯矢狀徑、外側脛骨平檯矢狀徑、脛骨平檯冠狀徑、內側脛骨平檯冠狀徑、外側脛骨平檯冠狀徑。MRI測量指標包括：脛骨平檯冠狀徑、內側脛骨平檯冠狀徑、外側脛骨平檯冠狀徑、內側脛骨平檯矢狀徑、外側脛骨平檯矢狀徑、內外側半月闆的厚度(前角、體部、後角)、內外側半月闆的寬度(前角、體部、後角)。解剖學測量的指標包括：脛骨平檯冠狀徑、內側脛骨平檯冠狀徑、外側脛骨平檯冠狀徑、內側脛骨平檯矢狀徑、外側脛骨平檯矢狀徑、內外側半月闆的厚度(前角、體部、後角)、內外側半月闆的寬度(前角、體部、後角)。結果在半月闆測量的直接指標中，除內側半月闆體部寬度、內側半月闆前角厚度、外側半月闆體部厚度的MRI測量變異繫數＜10%之外，所有指標變異繫數均＞10%。外側半月闆後角寬度及外側半月闆前角寬度的MRI測量，變異繫數分彆為65.97%、70.26%。半月闆測量的間接指標，變異繫數均＜10%。半月闆厚度的MRI測量總大于解剖學測量結果。3種測量方法的一緻性方麵存在關聯，但仍有差異。結論半月闆相關測量指標中，X線測量值均偏大，經MRI測量的指標與解剖學測量結果接近，MRI所測的半月闆指標較X線測量指標更具準確性及穩定性，值得推薦其作為臨床匹配性測量的方法，其中脛骨平檯冠狀徑、內側脛骨平檯矢狀徑、外側脛骨平檯矢狀徑是穩定性最好的3箇指標，變異繫數均＜7%，且脛骨平檯冠狀徑值得作為匹配性測量的首要指標。
목적：명학X선측량방법、MRI측량방법、해부학측량방법삼자적상호관계이급준학성화필배성。방법선취의외사망남성슬관절6지，년령20～45세，배제슬관절창상화질환，수궤편호，분별행X선표준정측위섭상、상규슬관절MRI소묘，장소득영상수거자료도입Unisight도상분석계통대상관지표진행측량병기록，연후장슬관절리단，직시하안조아원조직고적반월판측량방법진행측량병기록상관수거。X선측량지표포괄：내측경골평태시상경、외측경골평태시상경、경골평태관상경、내측경골평태관상경、외측경골평태관상경。MRI측량지표포괄：경골평태관상경、내측경골평태관상경、외측경골평태관상경、내측경골평태시상경、외측경골평태시상경、내외측반월판적후도(전각、체부、후각)、내외측반월판적관도(전각、체부、후각)。해부학측량적지표포괄：경골평태관상경、내측경골평태관상경、외측경골평태관상경、내측경골평태시상경、외측경골평태시상경、내외측반월판적후도(전각、체부、후각)、내외측반월판적관도(전각、체부、후각)。결과재반월판측량적직접지표중，제내측반월판체부관도、내측반월판전각후도、외측반월판체부후도적MRI측량변이계수＜10%지외，소유지표변이계수균＞10%。외측반월판후각관도급외측반월판전각관도적MRI측량，변이계수분별위65.97%、70.26%。반월판측량적간접지표，변이계수균＜10%。반월판후도적MRI측량총대우해부학측량결과。3충측량방법적일치성방면존재관련，단잉유차이。결론반월판상관측량지표중，X선측량치균편대，경MRI측량적지표여해부학측량결과접근，MRI소측적반월판지표교X선측량지표경구준학성급은정성，치득추천기작위림상필배성측량적방법，기중경골평태관상경、내측경골평태시상경、외측경골평태시상경시은정성최호적3개지표，변이계수균＜7%，차경골평태관상경치득작위필배성측량적수요지표。
Objective To investigate the interrelationship among the 3 methods of X-ray, MRI and anatomical measurements of human knee menisci, as well as their accuracy and matching degree. Methods Six qualiifed knee joints were selected from male adult patients whose death was accidental and age ranged from 20 to 45 years old. The cases of knee trauma and disorders were excluded, and the other cases were numbered randomly. Standard anterior-posterior and lateral X-ray imaging and routine knee MRI scan were performed respectively, and the image data were guided into the Unisight image analysis system so as to measure and record the relevant indicators. The knee joints were amputated, and the relevant data were measured and recorded under direct vision according to the meniscus measurement method in the Tissue Bank of our hospital. The X-ray measurement indicators included sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, coronal diameter of the tibial plateau, coronal diameter of the medial tibial plateau and coronal diameter of the lateral tibial plateau. The MRI measurement indicators included coronal diameter of the tibial plateau, coronal diameter of the medial tibial plateau, coronal diameter of the lateral tibial plateau, sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, thickness of the medial and lateral menisci ( anterior horn, body and posterior horn ) and width of the medial and lateral menisci ( anterior horn, body and posterior horn ). The anatomical measurement indicators included coronal diameter of the tibial plateau, coronal diameter of the medial tibial plateau, coronal diameter of the lateral tibial plateau, sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, thickness of the medial and lateral menisci ( anterior horn, body and posterior horn ) and width of the medial and lateral menisci ( anterior horn, body and posterior horn ). Results Among the direct measurement indicators of the meniscus, the coefifcient variations of all the indicators measured by the MRI were more than 10%, excluding the width of the body of the medial meniscus, the thickness of the anterior horn of the medial meniscus and the thickness of the body of the lateral meniscus, which were all less than 10%. The coefifcient variations of the width of the posterior and anterior horns of the lateral meniscus measured by the MRI were 65.97%and 70.26%respectively. The indirect measurement indicators of the meniscus indicated the variation coefifcient was less than 10%. The meniscus measured by the MRI was thicker than that of the anatomical measurement all the time. The consistency of the 3 measurement methods was interrelated, but differences still existed. Conclusions Among the measurement indicators of the meniscus, the X-ray measurement values are greatest, and the MRI measurement results are close to the anatomical measurement results. The indicators of the meniscus measured by the MRI are more accurate and stable than that by the X-ray, so it is recommended as the method to measure the clinical matching degree. The 3 best indicators of stability include the coronary diameter of the tibial plateau, sagittal diameter of the medial tibial plateau and sagittal diameter of the lateral tibial plateau, and the coefifcient variations are all less than 7%. Furthermore, the coronal diameter of the tibial plateau can be taken as the primary indicator in the measurement of matching degree.