骨盆Teepee像的影像解剖研究
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蔡鸿敏 CAI Hong-min 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
成传德 CHENG Chuan-de 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China doc_humane@163.com 
吴学建 WU Xue-jian 郑州大学第一附属医院骨科, 河南 郑州 450052  
王武超 WANG Wu-chao 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
汤金城 TANG Jin-cheng 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
常守亚 CHANG Shou-ya 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
段卫峰 DUAN Wei-feng 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
李无阴 LI Wu-yin 河南省洛阳正骨医院河南省骨科医院骨盆外科, 河南 洛阳 471002 Department of Pelvic Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang 471002, Henan, China  
期刊信息:《中国骨伤》2015年,第28卷,第5期,第408-411页
DOI:10.3969/j.issn.1003-0034.2015.05.005
基金项目:
中文摘要:

目的:研究骨盆Teepee像主体结构的影像解剖,包括其方位走行及影像解剖构成。

方法:对2013年6月至2014年6月进行骨盆CT检查的成人检查结果进行筛选,排除骨骼畸形及由肿瘤、创伤等所导致骨盆骨性破坏的患者。将所筛选出的9例全骨盆2.0 mm层厚轴向CT扫描图像作为研究对象,其中男7例,女2例;年龄(41.2±10.3)岁。应用Mimics 10.01对9例无病损全骨盆2.0 mm层厚轴向扫描数据进行三维重建。将重建出的骨盆三维图像进行透明化处理后向髋臼闭孔斜位及骨盆出口位逐渐旋转,直至髋臼上方区域出现标准的“圆锥形帐篷”(即Teepee)样外观。此时的图像即骨盆Teepee像,“圆锥形帐篷”即此投照像的主体。沿主体的边缘进行剪切,对主体及其以外的骨盆结构同时显示,然后研究其于整个骨盆内的方位走行及影像解剖构成。

结果:骨盆Teepee像所示主体起自髂前下棘后外侧骨皮质,经尾端、前方、外侧到头端、后方、内侧的指向,止于髂后上棘及髂后下棘之间的骨皮质。其由一顶、一底及两缘围成。其顶由髂骨的内板(形成其内缘)及外板(形成其外缘)的骨皮质相交形成,其底由坐骨大切迹形成。其内侧、下部、后方总包括小部分骶髂关节及所对应的骶骨侧骨质。

结论:骨盆Teepee像的主体为丰富的骨性结构,除其内下方小部分区域外可作为容纳某些类型骨盆、髋臼骨折固定物的安全区域。骨盆Teepee像可用于指导固定物的安全置入。
【关键词】骨盆  髋臼  骨折  骨折固定术,内  X线  体层摄影术,螺旋计算机
 
Radiographic anatomical analysis of the pelvic Teepee view
ABSTRACT  

Objectives:To research radiographic anatomy of the main structure of the pelvic Teepee view,including its azimuth direction and view anatomy structure.

Methods:From June 2013 to June 2014 adult pelvic CT examination results were filtered,excluding skeletal deformities and pelvic osseous destruction caused by tumors,trauma,etc. The data of 2.0 mm contiguous CT scan of 9 adults' intact pelves was selected and input into Mimics 10.01 involving 7 males and 2 females with an average age of (41.2±10.3) years old. Utilizing the software,the 3D CT reconstructions of the pelves were completed. Setting the transparency being high,the pelvic 3D reconstructions were manipulated from the pelvic anteroposterior view to the combined obturator oblique outlet view and fine-tuned till the regular Teepee-or teardrop-shaped appearance emerges. Cutting tools of the software were at the moment applied to separate the “Teepee” from the main pelvis for each reconstruction. Then the “Teepee” and the rest (main) part of the pelvis were displayed in different color to facilitate the analysis on the Teepee,iliac-oblique,and anteroposterior views.

Results:The “Teepee” started from the posterolateral aspect of the anterior inferior iliac spine and finished at the cortex between the posterior superior iliac spine and the posterior inferior iliac spine in a direction of being from caudal-anterior-lateral to cranial-posterior-medial. The radiographic anatomical composition of the “Teepee” contained one tip,one base,and two aspects. With the inner and outer iliac tables being the inner and outer aspects of the “Teepee”,the tip is consequently formed by their intersection. The base is imaged from the cortex of the greater sciatic notch. The medial-inferior-posterior portion of the “Teepee” contains a small part of sacroiliac joint and its corresponding side of bone of the sacrum.

Conclusions:The “Teepee” is a zone of ample osseous structures of the pelvis,aside from a small medial-inferior-posterior portion,the main zone of which can be accepted as a safe osseous zone for the anchor of implants stabilizing certain pelvic and acetabular fracture patterns. The Teepee view can be utilized as guidance for the safe percutaneous insertion of such implants.
KEY WORDS  Pelvis  Acetabulum  Fractures  Fracture fixation,internal  X-rays  Tomography,spiral computed
 
引用本文,请按以下格式著录参考文献:
中文格式:蔡鸿敏,成传德,吴学建,王武超,汤金城,常守亚,段卫峰,李无阴.骨盆Teepee像的影像解剖研究[J].中国骨伤,2015,28(5):408~411
英文格式:CAI Hong-min,CHENG Chuan-de,WU Xue-jian,WANG Wu-chao,TANG Jin-cheng,CHANG Shou-ya,DUAN Wei-feng,LI Wu-yin.Radiographic anatomical analysis of the pelvic Teepee view[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(5):408~411
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