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基于磁共振成像的经股骨骨锚定假体患者髋外展肌体积的三维肌肉重建:一项可行性研究。

Magnetic-resonance-imaging-based three-dimensional muscle reconstruction of hip abductor muscle volume in a person with a transfemoral bone-anchored prosthesis: A feasibility study.

作者信息

Leijendekkers Ruud A, Marra Marco A, Ploegmakers Marieke J M, Van Hinte Gerben, Frölke Jan Paul, Van De Meent Hendrik, Staal J Bart, Hoogeboom Thomas J, Verdonschot Nico

机构信息

a Department of Orthopaedics , Physical Therapy, Radboud University Medical Centre , Nijmegen , Netherlands.

b Radboud Institute for Health Sciences, Orthopaedic Research Laboratory , Radboud University Medical Centre , Nijmegen , Netherlands.

出版信息

Physiother Theory Pract. 2019 May;35(5):495-504. doi: 10.1080/09593985.2018.1453902. Epub 2018 Mar 28.

Abstract

BACKGROUND

Persons with transfemoral amputation typically have severe muscle atrophy of the residual limb. The effect of bone-anchored prosthesis use on existing muscle atrophy is unknown. A potentially feasible method to evaluate this is magnetic resonance imaging (MRI)-based three-dimensional (3D) muscle reconstruction. We aimed to (1) examine the feasibility of MRI-based 3D muscle reconstruction technique in a person with a cobalt-chrome-molybdenum transfemoral bone-anchored prosthesis; and (2) describe the change of hip abductor muscle volume over time.

METHODS

In this single case, 1-year follow-up study we reconstructed the 3D hip abductor muscle volumes semiautomatically from MRI scans at baseline, 6- and 12-month follow-up. The number of adverse events, difficulties in data analysis, time investment and participants' burden determined the level of feasibility.

RESULTS

We included a man (70 years) with a transfemoral amputation who received a bone-anchored prosthesis after 52 years of socket prosthesis use. No adverse events occurred. The accuracy of the 3D reconstruction was potentially reduced by severe adipose tissue interposition. Data analysis was time-intensive (115 h). Participants' burden was limited to 3-h time investment. Compared to baseline, the total hip abductor volume of both the residual limb (6 month: 5.5%; 12 month: 7.4%) and sound limb (6 month: 7.8%; 12 month: 5.5%) increased.

CONCLUSION

The presented technique appears feasible to follow muscle volume changes over time in a person with a cobalt-chrome-molybdenum transfemoral bone-anchored prosthesis in an experimental setting. Future research should focus on analysis of muscle tissue composition and the feasibility in bone-anchored prostheses of other alloys.

摘要

背景

经股截肢者的残肢通常会出现严重的肌肉萎缩。骨锚式假肢的使用对现有肌肉萎缩的影响尚不清楚。一种潜在可行的评估方法是基于磁共振成像(MRI)的三维(3D)肌肉重建。我们旨在:(1)检验基于MRI的3D肌肉重建技术在一名使用钴铬钼经股骨锚式假肢的患者中的可行性;(2)描述髋外展肌体积随时间的变化。

方法

在这项单病例、为期1年的随访研究中,我们在基线、6个月和12个月随访时从MRI扫描中半自动重建了3D髋外展肌体积。不良事件的数量、数据分析的困难程度、时间投入和参与者的负担决定了可行性水平。

结果

我们纳入了一名70岁的经股截肢男性,他在使用接受腔假肢52年后接受了骨锚式假肢。未发生不良事件。严重的脂肪组织插入可能会降低3D重建的准确性。数据分析耗时较长(115小时)。参与者的负担仅限于3小时的时间投入。与基线相比,残肢(6个月:5.5%;12个月:7.4%)和健侧肢体(6个月:7.8%;12个月:5.5%)的总髋外展肌体积均增加。

结论

在实验环境中,所提出的技术似乎可行,可用于跟踪使用钴铬钼经股骨锚式假肢的患者肌肉体积随时间的变化。未来的研究应侧重于肌肉组织成分的分析以及其他合金骨锚式假肢的可行性。

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