Lee Ki Won, Bae Joo Yul, Seo Dong-Kyo, Kim Sang Bum, Lee Hyun Il
Department of Orthopaedic Surgery, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea.
Department of Orthopaedic Surgery, Inje University, Ilsan Paik Hospital, Gyeonggi-do, Korea.
J Hand Surg Am. 2018 Aug;43(8):771.e1-771.e7. doi: 10.1016/j.jhsa.2018.01.003. Epub 2018 Feb 7.
This study aimed to establish normal values for wrist carpal alignment measured by 3-dimensional computed tomography (CT) and to show the inter- and intraobserver reliability of this measurement compared with simple radiography.
The study utilized 3-dimensional CT and simple radiography of wrist joints in 30 asymptomatic volunteers. The wrist position was standardized using a custom-designed positioning device. Three independent observers measured carpal alignment parameters including distal radius articular angle, radiolunate angle, radioscaphoid angle, radiocapitate angle, radius-third metacarpal angle, scapholunate angle, lunocapitate angle, and lunate-third metacarpal angle.
Based on 3-dimensional CT measurement, the mean values of these parameters were: 12.9° ± 1.8° for the distal radius articular angle; 1.2° ± 3.8° for the radiolunate angle; 54.2° ± 5.6° for the radioscaphoid angle; 1.9° ± 2.2° for the radiocapitate angle; -1.0° ± 2.5° for the radius-third metacarpal angle; 52.9° ± 6.9° for the scapholunate angle; 0.7° ± 4.1° for the lunocapitate angle; -2.3° ± 4.6° for the lunate-third metacarpal angle. All parameters showed high inter- and intraobserver reliability in the 2 modalities.
The normal values and ranges for carpal alignment angles were evaluated by using 3-dimensional CT. We could obtain high reliability in 3-dimensional CT as well as plain radiograph for the measurement of carpal alignment.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
本研究旨在确定通过三维计算机断层扫描(CT)测量腕部腕骨对线的正常值,并展示该测量方法与简单X线摄影相比,在观察者间和观察者内的可靠性。
本研究对30名无症状志愿者的腕关节进行了三维CT和简单X线摄影。使用定制设计的定位装置使腕部位置标准化。三名独立观察者测量了腕骨对线参数,包括桡骨远端关节角、桡月角、桡舟角、桡头角、桡骨-第三掌骨角、舟月角、月头角和月骨-第三掌骨角。
基于三维CT测量,这些参数的平均值为:桡骨远端关节角12.9°±1.8°;桡月角1.2°±3.8°;桡舟角54.2°±5.6°;桡头角1.9°±2.2°;桡骨-第三掌骨角-1.0°±2.5°;舟月角52.9°±6.9°;月头角0.7°±4.1°;月骨-第三掌骨角-2.3°±4.6°。所有参数在两种模式下均显示出高观察者间和观察者内可靠性。
通过三维CT评估了腕骨对线角的正常值和范围。在测量腕骨对线时,三维CT以及普通X线摄影均可获得高可靠性。
研究类型/证据水平:诊断性研究II级。