기계적 축에 수직으로 재구성된 삼차원 단층 촬영 영상을 이용하여 측정한 대퇴 경부 전염각의 측정
Femoral Neck Anteversion Measured Using a 3D CT Scan Perpendicular to the Mechanical Axis of the Femur
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목적: 기계적 축에 수직으로 촬영된 단층 촬영 영상을 이용하여 측정한 대퇴 전염각의 재현성과정확성을 알아 보고자 하였다. 대상 및 방법: 대퇴골의 기계적 축에 수직으로 촬영된 삼차원 단층촬영 영상 95예를 대상으로 하였다. 경부축은 경부가 대전자부로 이행하는 부위에서 측정한 방법(방법 1), 경부 기저부에서 측정한 방법(방법 2), 삼차원 재조합 모델로 측정한 방법(방법 3)으로 측정하였다. 원위 대퇴부의축은 해부학적 상과간 축, 수술적 상과간 축, 실제 후과간 축을 이용하였다. 결과: 방법 1로 측정한 전염각은 해부학적 상과간 축에 대해서는 4.79±6.41。, 수술적 상과간 축에 대해서는 6.09±6.58。, 실제 후과간 축에 대해서는 7.96±6.81。였다. 방법 2로 측정한 전경사 각은 해부학적 상과간 축에 대해서는 16.01±8.31。, 수술적 상과간 축에 대해서는 19.52±8.38。, 실제 후과간 축에 대해서는 21.79±8.52。였다. 방법 3으로 측정한 전염각은 실제 후과간축에 대해 20.15±12.89。였다. 결론: 대퇴골의 기계적 축에 수직으로 촬영된 삼차원 전산화 단층 촬영 영상을 이용한 전염각의측정은 재현성이 있는 측정 방법이며, 경부 기저부에서 측정하는 방법은 근위부에서 측정한 방법보다 정확하였고, 고식적 정의에 의해 측정한 방법과 통계적으로 의미 있는 차이는 없었다.
Abstract
Purpose: We wanted to measure the femoral neck anteversion (FNA) angles using a 3D CT scan that perpendicularly cut the mechanical axis of the femur and to assess the accuracy and reproducibility of different measuring methods. Materials and Methods: We obtained 95 cases of 3D CT images of the cross-section perpendicular to the mechanical axis of the femur. The methods used to measure the FNA angles included a method using the CT image of the area where the femoral neck is confluent to the greater trochanter (method 1), a method using the CT image taken from the neck base immediately prior to the beginning of the area of the lesser trochanter (method 2) and a method by which measurements are made after putting 3D bone models on a horizontal plane in virtual space (method 3). The reference axes of the distal femur we used were the anatomical transepicondylar axis, the surgical transepicondylar axis and the real posterior condylar axis. Results: The FNA angles measured by method 1 were 4.79±6.41。to the anatomical transepicondylar axis (ATEA),6.09±6.58。to the surgical transepicondylar axis (STEA) and 7.96±6.81。to the real posterior condylar axis (rPCA). The FNA angles measured by method 2 were 16.01±8.31。to the ATEA, 19.52±8.38。to the STEA and 21.79±8.52。to the rPCA. The FNA angles measured by method 3 were 20.15±12.89。to the rPCA. Conclusion: The measurement of the FNA angle using a 3D CT scan perpendicular to the mechanical axis is reproducible. The measurement method on the neck base level is more reliable than the one on the proximal neck confluence, and more similar to the measurement method by classic definition. Key Words: Femur, Anteversion angle, Mechanical axis, Computed tomography
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