Elahi M M, Lessard M L, Hakim S, Watkin K, Sampalis J
Department of Otolaryngology, McGill University, Montreal, Quebec, Canada.
J Craniofac Surg. 1997 May;8(3):213-21. doi: 10.1097/00001665-199705000-00014.
Preoperative knowledge of skull thickness before harvesting cranial bone grafts would be ideal to help minimize intracranial complications. Previous research has demonstrated regional variations in calvaria; however, accurate preoperative and intraoperative methods of skull thickness measurement are not available. The aim of this research represents the first attempt to examine the reliability of ultrasound to determine cranial bone thickness. Four previously studied calvarial sites were marked in 10 adult male cadaveric skulls. The individual points were insonified using an A-mode ultrasonic transducer operating in pulse-echo mode. The times of flight of the waves propagating in the bone samples were compared with caliper measurements. The mean difference in cranial bone thickness was 0.16 mm, with a standard deviation of 0.09 mm. Student's t-test failed to reveal any statistically significant differences between caliper and ultrasonic measurements (p = 0.569) and Pearson's correlation coefficient supported an extremely strong and positive relationship between the two modalities (r > 0.992). Multiple linear regression models predicted that calvarial thickness could be accurately predicted by ultrasound without consideration of cadaveric specimen or sampling point location (R2 = 0.988). The convergent values between ultrasonic and caliper measurements suggest that this modality can accurately and reliably determine skull thickness. A-mode ultrasound can have significant implications in guiding the harvest of in situ split cranial bone grafts, the placement of osseointegrated implants, skull anthropometrics, and related craniomaxillofacial applications.
在采集颅骨移植骨之前，若能预先了解颅骨厚度，将有助于最大程度减少颅内并发症，这是最为理想的情况。先前的研究已表明颅骨存在区域差异；然而，目前尚无准确的术前和术中颅骨厚度测量方法。本研究的目的是首次尝试检验超声测定颅骨厚度的可靠性。在10个成年男性尸体颅骨上标记出4个先前已研究过的颅骨部位。使用以脉冲回波模式运行的A型超声换能器对各个点进行超声检查。将在骨样本中传播的波的飞行时间与卡尺测量结果进行比较。颅骨厚度的平均差异为0.16毫米，标准差为0.09毫米。学生t检验未显示卡尺测量和超声测量之间存在任何统计学上的显著差异（p = 0.569），皮尔逊相关系数支持这两种测量方式之间存在极强的正相关关系（r > 0.992）。多元线性回归模型预测，无需考虑尸体标本或采样点位置，超声就能准确预测颅骨厚度（R2 = 0.988）。超声测量值与卡尺测量值的趋同表明，这种方法能够准确且可靠地测定颅骨厚度。A型超声在指导原位劈开颅骨移植骨的采集、骨整合植入物的放置、颅骨人体测量学以及相关的颅颌面应用方面可能具有重要意义。
