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目的:通过CT三维影像观测学龄期儿童(7~12岁)寰、枢椎形态结构,探索学龄期儿童寰、枢椎形态特征和增龄变化规律,为学龄期儿童寰、枢椎疾病的早期诊治和预防提供理论依据。方法:收集内蒙古医科大学附属医院及赤峰市第二医院2013~2014年行颈椎CT扫描的学龄期儿童影像资料,排除寰枢椎骨折、畸形、结核等疾病。将收集到的原始DICOM数据导入Mimics 16.0进行三维重建,运用软件的三维测量工具在重建的三维模型上对其寰、枢椎侧块及椎弓根相关指标进行测量,包括寰椎的侧块横径(LMD)、侧块内倾角(d角)、侧块前后径(LMB)、侧块上倾角(e角)、椎弓根宽度(AW)、椎弓根全长(AL)、椎弓根外偏角(b角)、椎弓根高度(AH)及椎弓根尾偏角(c角);枢椎的椎弓根全长(APL)、椎弓根宽度(APW)、椎弓根外偏角(f角)、椎弓根高度(APH)及椎弓根尾偏角(g角)。将观测对象按年龄每两岁为一组共分三组,即A组(7~8岁)、B组(9~10岁)、C组(11~12岁),并行统计分析。结果:LMD随年龄递增呈递增趋势,A组左侧为13.91±1.95mm,右侧为14.11±1.95mm;B组左侧为14.31±2.24mm,右侧为14.36±2.39mm;C组左侧为17.18±2.32mm,右侧为17.10±2.41mm;LMD左侧C组与A、B组间有统计学差异(P<0.05);LMD在各组左、右侧间比较有差异(P<0.05)。其他指标也随年龄呈递增趋势,同侧C组与A组比较除f角外均有显著差异(P<0.05);同侧C组与B组比较仅AH、APW及APH间存在显著差异(P<0.05);同侧A组与B组比较仅AL、AW、APL、APH及g角间存在显著差异(P<0.05);同组左、右侧间比较仅LMB和d角间有显著性差异(P<0.05)。结论:学龄期儿童寰枢椎椎弓根及侧块形态结构复杂,且发育未完全,对各骨性结构发育规律的三维结构形态进行观测,可为临床及进一步研究其周围毗邻结构提供参考依据。
OBJECTIVE: To observe the morphological changes of atlantoaxial and lateral vertebral bodies of school-age children (aged 7-12 years) by means of CT three-dimensional images and to explore the regularity of atlas and atherosclerosis in children of school age. Provide a theoretical basis for diagnosis and treatment. Methods: The images of school-age children underwent CT scan from 2013 to 2014 in the Affiliated Hospital of Inner Mongolia Medical University and the Second Hospital of Chifeng City were collected to exclude the atlantoaxial fractures, deformities and tuberculosis. The collected raw DICOM data were imported into Mimics 16.0 for 3D reconstruction. The 3D and 3D measurement tools of the software were used to measure the related indexes of the atlantoaxial and lateral pedicles and pedicles in the reconstructed 3D model. (LMD), lateral incline (d angle), lateral anteroposterior diameter (LMB), lateral elevation (e angle), pedicle width (AW), total pedicle length (B angle), pedicle height (AH) and pedicle caudal angle (c angle); total pedicle length (APL), pedicle width (APW), pedicle Angle (f angle), pedicle height (APH) and pedicle caudal angle (g angle). The subjects were divided into three groups according to the age of two-year-old group, that is, group A (7-8 years), group B (9-10 years old), group C (11-12 years old), parallel statistical analysis. Results: The LMD showed an increasing trend with age, the left side of group A was 13.91 ± 1.95mm and the right side was 14.11 ± 1.95mm; the left side of group B was 14.31 ± 2.24mm and the right side was 14.36 ± 2.39mm; the left side of group C (17.18 ± 2.32mm) and the right (17.10 ± 2.41mm). There was a significant difference (P <0.05) between the left side of LMD and the A and B groups. There was significant difference between the left and right side of LMD in each group (P < 0.05). The other indexes also showed an increasing trend with age. There was a significant difference (P <0.05) between the ipsilateral C group and the A group except for the f angle (P <0.05). There was significant difference between the ipsilateral C group and the B group only in AH, APW and APH (P <0.05). There was significant difference between the ipsilateral A group and the B group only in AL, AW, APL, APH and g angle (P <0.05) Sex differences (P <0.05). Conclusions: The morphology and structure of pedicle and lateral mass of atlantoaxial pediatric at school are complex and incompletely developed. The three-dimensional structure and morphology of each bony structure are observed and can provide reference for clinical and further study of its adjacent structures .