双源CT测量前交叉韧带单束重建术后隧道位置的临床研究

目的:应用双源CT(Dual-source computer tomography,DSCT)测量前交叉韧带(Anterior cruciate ligament,ACL)单束重建术后胫骨、股骨隧道位置,并对隧道位置进行评价。方法:对2013年1月至2014年6月我科收治的92例(男64例,女28例,平均年龄31.2岁)ACL单束重建患者术后膝关节进行双源CT三维重建,应用Adobe Photoshop CS6软件圈画隧道中心并采用Lorenz法测量胫骨隧道中心点相对位置百分比(Tx,Ty),采用Bernard四格表法测量股骨隧道中心点相对位置百分比(Fx,Fy)。结果:Tx平均为(54.54±3.42)%,Ty平均为(39.58±6.72)%,Fx平均为(28.98±6.51)%,Fy平均为(28.04±8.70)%。男、女性及左、右膝之间Tx、Ty、Fx、Fy的差异均无统计学意义(P0.05)。结论:双源CT能够清晰,三维显示ACL术后隧道,可以用来评估隧道位置,为改进前交叉韧带损伤后的手术方式及个体化解剖重建提供帮助。

Measurement of Tunnel Location with Dual-source CT Following Single-bundle Reconstruction of Anterior Cruciate Ligament

Objective:To measure and analyze the tibia and femur tunnel location after single-bundle reconstruction of anterior cruciate ligament using dual-source CT.Methods:DSCT scanning of the knee joint was performed in the 92 patients who underwent single-bundle ACL reconstruction from January 2013 to June 2014. These patients included 64 men and 28 women, with an average of 31.2 years. The centers of bone tunnels were marked with Adobe Photoshop CS6. The tibial tunnel center was measured with Lorenz method (relative position represented with Tx\Ty in percentage) and femoral tunnel center was measured with Bernard method(relative position represented with Fx\Fy in percentage).Results:The average Tx and Ty were (54.54± 3.42)%and (39.58± 6.72)%, while the average Fx and Fy were (28.98± 6.51)%and (28.04± 8.70)%. There was no significant difference between male and female, left and right knee(P>0.05).Conclusion:Dual-source CT can clearly, three-dimensional display the operative tunnel of anterior cruciate ligament. It also can be used to evaluate tunnel location, help improve operation method and provide individualized anatomic reconstruction for the injury of anterior cruciate ligament.