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Objective :To investigate the characteristics of ankle talus by CT scanning in patients with Kashin-Beck disease. Methods: We included 40 patients with ankle pain for this study. CT examination was carried out to measure talus diameter, i.e., from the upper at inside to the lower at outside and from the upper at outside to the lower at inside in coronal direction; from the upper at front to the lower at behind, from upper at front to the upper at behind in sagittal direction. The statistically significant indexes were included in the ROC curve analysis. Results :CT measurement of the talus in ankle joints showed that the distance of the talus in ankle joints from the upper at outside to the lower at inside (3.76±0.34)cm, the upper at front to the lower at behind (4.98±0.36)cm in KBD group were significantly lower than those in OA group (4.26±0.34)cm and (5.40±0.37)cm, which was significantly difference (t=-3.599, 4.646, P=0.00). ROC curve analysis showed that there was significant difference between KBD group and OA group, and the cut-off value of the distance from the upper at outside to the lower at inside was 4.055cm, with sensitivity of 70% and specificity of 90%. When the cut-off value of the distance from the upper at front to the lower at behind was 5.41cm, the sensitivity was 65% and the specificity was 95%. Conclusion: The distance of the talus of KBD ankle joints from the upper at outside to the lower at inside (cut-off value of 4.055 cm) in coronal direction and the upper at front to the lower at behind (cut-off value was 5.41 cm) in sagittal direction can be used as specific diagnostic indicators of ankle joint damage for KBD in adults.
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10.3969/j.issn.2095-4344.2013.26.016
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Objective:To explore the effective treatment way of orbital zygomatic fracture with diplopia,reduce orbital capacity and regenerate referenced criterion of orbital capacity.Methods:To compare three-dimensional CT orbital diameters between before and after operation,and then reduce orbital capacity with special material.Results:Three-dimensional CT orbital diameter measurement can realize fracture shift and orbital capacity change accurately.Three-dimensional CT orbital diameter measurement before and after operation provides an important basis for orbital reconstruction.Conclusions:three-dimensional CT orbital diameter measurement is very simple,accurate and important for orbital zygomatic fracture treatment and orbital reconstruction.
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Objective To provide useful suggestion for the prevention and treatment of osteoporosis by analyzing the density of the lumbar vertibra of normal Uygar and Han people in Xinjiang.Methods Normal Uygar males were 104,Uygar females were 85, Han males were 230,Han females were 182,the age ranged from 20 to 69 and was divided into five groups.Cann-Genant method was adopted to make human skeleton model,by which the density of bone was worked out.Results (1)The bone density was obviously negatively interrelated to age (?
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At present the newer computerized tomography scanners provide a means for direct measurement of the size of normal and abnormal body structures from monitor. In orthopedics and rheumatology, CT is very important and useful means to make correct diagnosis and treatment modalities. In spite of its increasing importance in orthopedic field, reports about accuracy of CT are not common. We reviewed several reports that described about anatomical measurement using CT or similar experiments to our study. But there are few statements that have directly compared CT and caliper measurements in spine or other bones. So, authors performed experiments with 36 vertebrae of 8 pig spines to know the difference of CT measurement from actual measurement. The results were as follow: 1. In CT, bony portions including diameter of body and both pedicles were overestimated about 5% than actual ones. 2. In CT, AP and lateral diameters of spinal canal were 6~7% smaller than actual measurement and canal area, estimated by the products of AP and lateral diameter of spinal canal, is about 13% smaller than actual size. 3. It is the result of cortical overestimation around canal that spinal canal area was estimated less than actual size. 4. Main cause of this differences was partial volume effect that developed during CT scanning. In conclusion, CT scanner is the useful means and gives many useful informations to diagnose the spinal disease, but the physicians must understand mechanical, physical and mathematical limitations of CT and discrepancy of measurement data.
Subject(s)
Diagnosis , Orthopedics , Rheumatology , Spinal Canal , Spinal Diseases , Spine , Tomography, X-Ray ComputedABSTRACT
Since developmental lumber atenosis was described by Verbiest in 1954, there have been many reports on lumbar stenosis. But there have been many limitations in diagnosis and treatment of lumbar stenosis. Recently, the development of water-soluble contrast media and high resolution spine CT scan have not only brought about significant progress in diagnosis of the etiology and levels of lumbar stenosis, but also better surgical therapetic results could be expected. The author has reviewed 433 patients with lumber stenosis operated at the department of Neurosurgery YUMC Yongdong Severance hospital from March 1983 to September 1987 and analyzed the measurements of various parts of the spinal canal by high resolution spine CT scan, and evaluated the clinical courses and their surgical outcomes. The results were summarized as following: 1) Male to female ratio was 1:1.3. The peak age incidence were 40's in male and 50's in female. 2) By the causes of lumbar stenosis, degenerative stenosis was most common as 78%, and followed by degenerative spondylolisthesis 7.2%, spondylolytic spondylolisthesis(1.6%), iatrogenic stenosis(1.6%), developmental stenosis(0.7%) and posttraumatic stenosis(0.7%). 3) Single level stenosis was most common(47.1%), two levels 32.8% and three levels or more 20.1%. In the single level stenosis L4/5 was most common as 85.8% and L5/S1 10.3%. In the two levels stenosis, L4/5 and L4/S1 were most common at 72.5% and L3/4 and L4/5 26.1%. 4) The characteristic clinical symptoms were chronic back pain and neurogenic intermittent claudication(65.6%). Few patient showed abnormal neurological findings. Common abnormal sign was loss or decrease of ankle jerk(73%). The straight leg raising test was not significant, and it was positive only in 10.3%. 5) In diagnosis of lumbar stenosis, it was most important to identify the causes of lumbar stenosis and degree of compression on cauda equina, or lateral recess stenosis by the spine CT or spine CT myelograms. 6) On myelogram, the findings of complete or incomplete block were present in 44.1%, and indentations of contrast dye column at the levels of stenosis was noted in 55.9%. 7) The common findings on spine CT scan were hypertrophy of posterior articular facet joints(65.8%), osteophyte formation(37.1%), thicking of yellow ligament(21.7%), ossification of posterior longitudinal ligament(23.8%), ossification of yellow ligament(4.9%). 8) In the diagnosis of degenerative lumbar stenosis with high resolution of spine CT scan, anteroposterior diameter of spinal canal was not so significant, but the cross sectional areas of dural sac and spinal canal were most sensitive indexes. The anteroposterior diameter of dural sac and interfacetal distance provided th e clue of lumbar stenosis. If the anteroposterior diameter of the lateral recess was less than 3mm it could be diagnosed as the lateral recess stenosis. And if the angle between both yellow ligaments(yellow ligament angle, Y-angle) was less than 60( it must be suspected as the central stenosis. 9) In the examination of degenerative spondylolisthesis with spinal CT scan, anterior-posterior diameter and cross sectional area of spinal canal and dural sac at the disc level were smaller than those of upper and lower vertebral levels. The angle of yellow ligament was almost normal. 10) For the definite treatment wide decompressive laminectomy, medial facetectomy and foraminotomy should be carried out. 11) Our results of surgery were good to excellent in 90.3% and fair to poor 9.7%.