CAJ | 학술논문

目的研究Kienb(o)ck病患者病变月骨的显微形态学特点.方法使用MicroCT对17例Kienb(o)ck病患者的月骨标本进行扫描,并进行三维重建,测量并统计滋养孔数量和直径.将横断面图像重建后,分别选取4个兴趣区,计算各兴趣区内骨小梁参数,分析骨小梁结构特点,并与正常月骨数据进行对比.结果所有病变月骨均有不同程度的骨质连续性的破坏,表现为类似于远端关节面分离的青枝骨折.在对病变月骨远端关节面不同部位骨小梁参数的统计分析中发现,中段骨小梁的骨组织体积、密度、骨小梁分离度和结构模型指数均与掌、背侧差异有统计学意义(P＜0.05).比较病变月骨与正常月骨中央骨小梁参数时发现其在骨组织体积、密度、骨组织表面积、骨小梁厚度、分离度和骨小梁模式因子等方面差异有统计学意义(P＜0.05).病变月骨掌侧滋养孔数量显著多于背侧(P＜0.05),病变月骨掌侧滋养孔的直径小于正常月骨,两者差异有统计学意义(P＜0.01).结论 Kienb(o)ck病患者的病变月骨在显微结构方面既表现出骨质破坏和骨小梁重塑的特点,也表现出相对于正常月骨的血运破坏和血管再生的迹象.
목적 연구Kienb(o)ck병환자병변월골적현미형태학특점.방법 사용MicroCT대17례Kienb(o)ck병환자적월골표본진행소묘,병진행삼유중건,측량병통계자양공수량화직경.장횡단면도상중건후,분별선취4개흥취구,계산각흥취구내골소량삼수,분석골소량결구특점,병여정상월골수거진행대비.결과 소유병변월골균유불동정도적골질련속성적파배,표현위유사우원단관절면분리적청지골절.재대병변월골원단관절면불동부위골소량삼수적통계분석중발현,중단골소량적골조직체적、밀도、골소량분리도화결구모형지수균여장、배측차이유통계학의의(P＜0.05).비교병변월골여정상월골중앙골소량삼수시발현기재골조직체적、밀도、골조직표면적、골소량후도、분리도화골소량모식인자등방면차이유통계학의의(P＜0.05).병변월골장측자양공수량현저다우배측(P＜0.05),병변월골장측자양공적직경소우정상월골,량자차이유통계학의의(P＜0.01).결론 Kienb(o)ck병환자적병변월골재현미결구방면기표현출골질파배화골소량중소적특점,야표현출상대우정상월골적혈운파배화혈관재생적적상.
Objective To analyze the microstructure of the lunates in patients with Kienb(o)ck's disease using micro-computer tomography (MicroCT).Methods Fresh lunates from 17 patients with Kienb(o)ck disease were scanned with the MicroCT.The scanned data were reconstructed with the DateViewer software for analysis of the number and size of nutrient foramina.Four regions of interest were chosen in a transverse plane of the reconstructed 3D images.A serial of the trabecular indexes were calculated and compared with those from the normal lunates.Results All the Kienb(o)ck's lunates had various degrees of discontinuity of the cortex,mimicking greenstick fracture with separation of the distal joint surface.Within the 3 ROIs of the distal surface,the BV, BV/TV, Tb.Sp and SMI of the middle ROI were significantly different than those of the volar and dorsal ROIs (P ＜ 0.05).Comparing the central trabecular bones of the Kienb(o)ck' s lunates with those of the normal lunates revealed that the BV, BV/TV, BS, Tb.Th, Th.Sp and Tb.Pf were significantly different (P ＜ 0.05).As to the nutrient foramina, we found that the volar nutrient foramina number was significant higher than that of the dorsal ones (P ＜ 0.05).Also the diameters of the volar nutrient foramina of the Kienb(o)ck's lunates were significantly smaller than those of the normal lunates (P ＜ 0.01).Conclusion Both destruction as well as remodeling of the trabecular bones and blood supply damage as well as angiogenesis exist in the Kienb(o)ck' s lunates.