Laboratoire de Biomécanique Appliquée, Aix Marseille Univ, IFSTTAR UMR T24, Marseille, France.
Service de chirurgie viscérale et endocrinienne, Angers University Hospital, Rue Larrey, 49933, CEDEX 9, Angers, France.
Hernia. 2024 Apr;28(2):485-494. doi: 10.1007/s10029-023-02939-0. Epub 2024 Jan 4.
The width of the Linea alba, which is often gauged by inter-rectus distance, is a key risk factor for incisional hernia and recurrence. Previous studies provided limited descriptions with no consideration for width, location variability, or curvature. We aimed to offer a comprehensive 3D anatomical analysis of the Linea alba, emphasizing its variations across diverse demographics.
Using open source software, 2D sagittal plane and 3D reconstructions were performed on 117 patients' CT scans. Linea alba length, curvature assessed by the sagitta (the longest perpendicular segment between xipho-pubic line and the Linea alba), and continuous width along the height were measured.
The Linea alba had a rhombus shape, with a maximum width at the umbilicus of 4.4 ± 1.9 cm and a larger width above the umbilicus than below. Its length was 37.5 ± 3.6 cm, which increased with body mass index (BMI) (p < 0.001), and was shorter in women (p < 0.001). The sagitta was 2.6 ± 2.2 cm, three times higher in the obese group (p < 0.001), majorated with age (p = 0.009), but was independent of gender (p = 0.212). Linea alba width increased with both age and BMI (p < 0.001-p = 0.002), being notably wider in women halfway between the umbilicus and pubis (p = 0.007).
This study provides an exhaustive 3D description of Linea alba's anatomical variability, presenting new considerations for curvature. This method provides a patient-specific anatomy description of the Linea alba. Further studies are needed to determine whether 3D reconstruction correlates with pathologies, such as hernias and diastasis recti.
白线的宽度（通常通过腹直肌间距离来测量）是切口疝和复发的关键风险因素。之前的研究虽然提供了有限的描述，但没有考虑到宽度、位置变异性或曲率。我们旨在提供白线的全面 3D 解剖分析，重点是其在不同人群中的变化。
使用开源软件，对 117 名患者的 CT 扫描进行了 2D 矢状面和 3D 重建。测量了白线的长度、由矢状面评估的曲率（耻骨联合线和白线之间最长的垂直段）以及沿着高度的连续宽度。
白线呈菱形，脐部最宽处为 4.4±1.9cm，脐上宽度大于脐下。其长度为 37.5±3.6cm，随体重指数（BMI）增加（p<0.001），且女性较短（p<0.001）。矢状面为 2.6±2.2cm，肥胖组高 3 倍（p<0.001），随年龄增加（p=0.009），但与性别无关（p=0.212）。白线宽度随年龄和 BMI 增加（p<0.001-p=0.002），在脐和耻骨之间的女性中间部位明显更宽（p=0.007）。
本研究提供了白线解剖变异性的详尽 3D 描述，提出了曲率的新考虑因素。该方法提供了白线的患者特异性解剖描述。需要进一步研究以确定 3D 重建是否与疝和腹直肌分离等疾病相关。
