基于CT三维重建的肩胛冈解剖形态学分型及其临床意义

doi:10.13418/j.issn.1001-165x.2021.04.010

摘要/Abstract

摘要： 目的　探讨基于CT三维重建的肩胛冈解剖形态学分型及其临床意义。方法　选取在遵义医学院附属医院放射科对患侧肩胛骨进行CT平扫的319名患者（左肩179例，右肩140例），进而对患侧肩胛骨三维重建形态并分型。假设肩胛冈内侧端与肩胛骨内侧缘交点为A点，冈盂切迹与肩胛冈上缘的交点为B点，冈盂切迹为C点，肩峰内侧缘为D点，肩峰外侧缘为E点，AB的内1/3点为F ，AC的内1/3点为G，AB的外1/3点为H，AC的外1/3点为I，FG的中点为J，HI的中点为K，BC的中点为L。研究参数：AB、AC、AD、AE、BC、HI、FG的距离；B、H、F、L、K、J、E、I、G的厚度。结果　CT重建下肩胛冈形态分为6型：大梭型、小梭型、木棒型、粗杆型、S型和细杆型。AE、BC、AC以及AD的长度大梭型、木棒型和粗杆型长于小梭型，S型和细杆型 (P<0.05)。AB的长度大梭型长于木棒型和细杆型 (P<0.05)。FG的高度大梭型高于小梭型 (P<0.05)。HI的高度大梭型高于其他所有类型 (P<0.05)。B、C、H、K、I、F、J以及G的厚度，大梭型以及粗杆型厚于细杆型以及小梭型 (P<0.05)。结论　CT三维重建下肩胛冈分为6型：大梭型、小梭型、木棒型、粗杆型、S型和细杆型。不同的肩胛冈形态分型为临床医生选择内固定以及手术方式提供解剖学依据。

关键词: 肩胛冈, 　解剖形态学, 　CT三维重建

Abstract: 　Objective To explore morphological classification of scapular spine based on three-dimensional reconstruction of CT and its clinical significance. Methods Three hundred and nineteen patients (179 cases of left shoulder and 140 cases of right shoulder) from the department of Radiology in the affiliated Hospital of Zunyi Medical College were scanned by CT, and then the three-dimensional reconstruction and classification of the affected scapular spine were performed. It was assumed that the point of intersection between the medial end of the scapular spine and the medial margin of the scapula was point A. The intersection of the glenoid notch and the superior margin of the scapular spine was point B. The glenoid notch was point C. The medial edge of the acromion was point D. The lateral edge of the acromion was point E. The inner 1/3 point of AB was point F. The inner 1/3 point of AC was point G. The outer 1/3 point of AB was point H, the outer 1/3 point of AC was point I, the midpoint of FG was point J, the midpoint of HI was point K, the midpoint of BC was point L. Research parameters were the following: the distance between point A and point B, point A and point C, point A and point D, point A and point E, point B and point C, point H and point I, point F and point G, and the thickness of B, H, F, L, K, J, E, I, G. Results The shape of the inferior scapular spine reconstructed by CT can be divided into 6 types: large fusiform-type, small fusiform-type, wooden club-type, thick rod-type, S-type and slender rod-type. The length of AE, BC, AC and AD in large fusiform-type, wooden club-type and thick rod-type was longer than that of small fusiform-type, S-type and slender rod-type. The length of AB in large fusiform-type was longer than that of wooden club-type and slender rod-type (P<0.05). The height of FG in large fusiform-type was higher than that in small fusiform-type. The height of HI in large fusiform-type was higher than that of all other types (P<0.05). The thickness of B, C, H, K, I, F, J and Gin large fusiform-type and thick rod-type were thicker than those of slender rod -type and small fusiform-type (P<0.05). Conclusions The scapular spine can be divided into 6 types based on the CT three-dimensional reconstruction: large fusiform-type, small fusiform-type, wooden club-type, thick rod-type, S-type and slender rod-type. Different morphological types of scapular spine provide anatomical basis for clinicians to choose internal fixation and operation methods.

Key words: Scapular spine, 　Anatomic morphology, 　CT three-dimensional reconstruction

中图分类号:

R322

余浩, 邓晚秋, 桑鹏, 刘毅. 基于CT三维重建的肩胛冈解剖形态学分型及其临床意义[J]. 中国临床解剖学杂志, 2021, 39(4): 415-419.

Yu Hao, Deng Wanqiu, Sang Peng, Liu Yi. The morphological classification and clinical significance of the scapular spine based on CT three-dimensional reconstruction[J]. Chinese Journal of Clinical Anatomy, 2021, 39(4): 415-419.

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