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The Establishment of Anatomy Database of Chinese Normal Limb Bones and Joins

Author: LiJun
Tutor: ChenAiMin
School: Second Military Medical University
Course: Surgery
Keywords: lower limb bone anatomy Parameter three-dimensional CT reconstruction database
CLC: R322.7
Type: Master's thesis
Year: 2011
Downloads: 40
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Abstract

【Research background】Currently, foreign orthopedic fixations are designed by the anatomy database of westerners’normal bones and joins. Because the anatomy database of normal bones and joins has not been established in our country, the orthopedic fixations of the lower limb madden by domestic enterprise are the copy of westerners’and the geometry is not suitable for Chinese anatomical and physiological feature of bones and joins. To make the designing of the orthopedic fixations be suitable for Chinese anatomical and physiological feature, the Chinese database of the normal limb bones and joins should be established. Then, we can reduce the trauma in operation, reduce the rate of the orthopedic fixations’fracture, loosening and ablate, and also can increase the rate of fracture healing. And we can do something for designing, manufacture, mechanical analysis and clinical application of the orthopedic fixations.Nowadays, the traditional methods for radiography measurements are include of surveying on X-ray plain film, plain CT scan, plain MRI scan and specimen. Although surveying on X-ray plain film is convenient and direct-viewing, it is affected by measuring the angle, position and distance, and it can not be measured in Three-dimensional image. So we measure the length of femoral, tibia and fibula, and the isthmus diameter and cortical bone’s cutting edge angle of femur and tibia on X-ray plain film in this research. Due to such factors as air-dried specimen, there is error when they are measured, and the other items such as the bone’s marrow cavity could not be easy to measure. And plain CT or MRI scans are two-dimensional images, they are not three-dimensional images.In1989, the American visible human project promoted the development of the research in the medical image processing and digital body. It has great significance for the development of digital medicine. Three-dimensional CT reconstruction become mature technology, it is widely used in clinical medicine. Three-dimensional CT reconstruction has more advantage than the traditional methods. It can be observed at any angle and direction in the mages, and be easy to make marks for reducing error. So, three-dimensional reconstruction technique takes new idea and method for this study.The memory capacity of the SQL Server 2008 is very large, and we can input and inquiry the data on the internet by it. Although the sample size and the item of this study is not large, it provides a platform for establishing a database of Chinese normal limb bones and joins which has large sample, cross-regional and multi-ethnic bodies. 【Objective】The anatomy parameters of Chinese normal limb bones and joins are measured on X-ray plain films and three-dimensional CT images. The data are statistically analyzed, and each parameter’s mean and standard deviation are calculated. When the Chinese anatomy parameters are compared with westerner’s, there is the significant deviation between them. Finally, the data and the images are inputted into the software of SQL Server 2008 for enquiry and application.【Method】1、subject and image acquisition(1) 150 volunteers whose age ranged from 19 to 73 are from the eastern China, and their average age is 52.8 years. All the volunteers are healthy or with mild cataplasia knee, and all of them are without deformity, tumor, fracture and surgery of their lower limb in case history.(2)150 volunteers’X-ray plain films of Femur, tibia and fibula have been obtained by Philips DR instrument, While 150 volunteers’CT scans have been obtained by TOHSIBA Aquilion CT instrument.2、Three-dimensional CT reconstructionThe CT Dicom format of Hip, knee and ankle is inputted into Mimics 10.01 on personal computer, and then three-dimensional CT image which can be rotated and segmented, are finished by the steps such as thresholding, removing noise, separating structure and smoothing image.3、Measurement(1) The Dicom format of Anteroposterior and lateral X-ray plain film of femur, tibia and fibula is inputted into the software of Dicom Explorer. And then, the length of femur, tibia and fibula, the length of isthmus (the diameter difference< 1mm) and the cortical bone’s cutting edge angle of femur and tibia are measured on X-ray plain films.(2) 22 anatomic parameters such as femoral neck shaft angle, the width of femoral condyle and the width of tibial plateau etc are measured on the three-dimensional CT images of hip, knee and ankle.4、Input data into the database software The data and radiographic images are inputted into the database software of SQL Server 2008 for enquiry and application.【Result】1、The measured anatomic parameters are statistically analyzed to calculate their mean and standard deviation with SPSS15.0. For example, the length of femur(the mid-point greater trochanter of femur to lateral femoral condyle)382.3±7.8 mm, the transverse diameter of femoral stenosis 25.0±0.8 mm, femoral neck shaft angle129.1±6.5°, the width of femoral condyle 70.8±5.1 mm, the width of tibial plateau68.2±4.6 mm.2、Taken the measured value of TP-TSA and PS which are compared with westerner’s by t-text for example,there is significant deviation between them.【Conclusion】1、The measurement on three-dimensional CT image has more advantage than the traditional measurement methods. Not only can three-dimensional CT image be clearly and directly observed, but also they can be cutted up, perspected and rotated to be convenient for measurement and reducing error. And, it provides a new technology and method for anatomical measurement of bones.2、The database software of SQL Server 2008 has large memory capacity, and we can also transmit information on the internet by it. Although the time of this study is short and the sample is limited, it provides a platform for establishing a database of Chinese normal limb bones and joins which has cross-regional and multi-ethnic bodies.3、We found that the import orthopedic fixations and the copy one are not suitable for Chinese anatomical and physiological feature of in long-term clinical study. So, it is important to establish the anatomy database of Chinese limb bones and joins. On the one hand, we can manufacture the orthopedic fixations which are suitable for Chinese physiological feature by CAD and CAM in the future. On the other hand, it can help us for surgery, clinical teaching and the biomechanical analysis of the limb bones.

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