文章摘要
苏启航,张锦飙,李聪,张岩,潘杰,李立钧,谭军.脊柱胸腰段骨折椎体的三维形态学分析.骨科,2019,10(5):379-383
脊柱胸腰段骨折椎体的三维形态学分析
Three-dimensional morphological analysis of thoracolumbar vertebrae fracture
投稿时间:2019-05-12  
DOI:10.3969/j.issn.1674-8573.2019.05.003
中文关键词: 脊柱骨折  三维断层扫描成像  Mapping技术
英文关键词: Spinal fractures  Imaging, three-dimensional, tomography scanners  Mapping
基金项目:国家重点研发计划项目(2017YFA0105404);上海市卫生局科研计划项目(20134025)
作者单位E-mail
苏启航 同济大学附属东方医院骨科上海 200120  
张锦飙 同济大学附属东方医院骨科上海 200120  
李聪 同济大学附属东方医院骨科上海 200120  
张岩 同济大学附属东方医院骨科上海 200120  
潘杰 同济大学附属东方医院骨科上海 200120  
李立钧 同济大学附属东方医院骨科上海 200120  
谭军 同济大学附属东方医院骨科上海 200120平湖市第二人民医院骨科浙江嘉兴 314200 dr_tanjun@tongji.edu.cn 
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中文摘要:
      目的 通过三维骨折线分布图的大数据形态学分析,揭示脊柱胸腰段椎体(T11~L2)骨折的好发模式及骨折特点,从而指导临床决策。方法 回顾性分析2017年1月至2019年3月AO分型为A型的压缩性胸腰段椎体(T11~L2)骨折病人的临床资料。共纳入了257例研究对象,平均年龄为46岁,266个骨折椎体,其中T11骨折15例,T12骨折69例,L1骨折95例,L2骨折87例。把病人高分辨率CT数据导入到Mimics软件中,通过阈值分割,重建出骨折椎体模型。依次将各个骨折椎体的骨折线临摹到相应正常椎体模型上,获得各个椎体节段的3D骨折线分布图。结果 3D骨折线分布图揭示骨折线主要集中在椎体的上半部分以及椎体的外1/3部分,并且沿着椎体的前方和侧方呈环状楔形分布。结论 首次将骨折的Mapping技术应用到胸腰段骨折的分析研究中,骨折线分布图揭示了胸腰段骨折的好发模式及形态学特点,从流行病学及形态学方面提高了对胸腰段骨折的认识,有助于提升后续的科学研究及改善临床决策。
英文摘要:
      Objective To produce fracture maps of the thoracolumbar (TL) fracture vertebral body (T11-L2) using CT mapping as a big data visualization method, and reveal recurrent patterns and characteristics of the TL fractures. Methods We undertook a retrospective analysis on the CT imaging data of patients with TL fractures (type A, AO fracture classification system) between January 2017 and March 2019. This study consisted of 257 patients with an average age of 46 years old. A total of 266 fracture vertebrae were collected, which comprised of 15 T11 vertebral fractures, 69 T12 vertebral fractures, 95 L1 vertebral fractures and 87 L2 vertebral fractures. Raw CT data were acquired utilizing a 64 channel CT scanner, and then imported into Mimics software to create three-dimensional reconstruction models, which were superimposed and oriented to fit a model vertebral template by both aligning specific bio-landmarks and reducing reconstructed fracture fragments. Fracture lines were found and traced in order to create a fracture map of the vertebral body. Results Three-dimensional maps showed that the fracture lines tended to be concentrated in the upper half and outer third of the vertebral body, as well as being distributed in annular wedges along the anterior and lateral sides of the vertebral body. Conclusion Fracture maps revealed recurrent patterns and characteristics of the TL fracture vertebral body, which improves the understanding of TL fracture, as well as helping to increase opportunities for follow-up research and aid clinical decision-making.
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