Femoral neck anterversion angle

Femoral neck anterversion angle

定义

Stephan Mahler

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股骨颈前倾角(或称股骨前倾、前倾角、股骨扭转角)是用于评估股骨构型的测量指标,尤其用于研究犬前十字韧带断裂的易感性。股骨颈前倾角股骨颈与股骨骨干之间的夹角。X线摄影是测量股骨颈前倾角最简便的方法,但X线片易受体位误差影响,从而影响测量值。因此,也可通过股骨的多平面重建进行评估。

目前已有多种测量股骨颈前倾角的方法见诸报道。

第一种方法为X线摄影法,需对股骨拍摄两个相互垂直的投照位。

第一个投照位为髋关节及股骨的腹背位X线片。犬取背卧位,后肢向尾侧伸展,两侧股骨相互平行。满足以下条件则认为体位摆放满意:

第二个投照位为股骨内外侧位X线片。两侧内侧髁外侧髁完全重叠则认为体位摆放满意。

在两个投照位上,均以最佳拟合圆勾画股骨头轮廓以确定其圆心(A)。分别确定矢状面和额状面上的股骨解剖轴。测量矢状面股骨解剖轴与股骨头圆心之间的距离(a),以及额状面股骨解剖轴与股骨头圆心之间的距离(b)。股骨颈前倾角(alpha)由以下公式计算:tan⁻¹(a/bF)。

已发表的股骨颈前倾角数值如下:

拉布拉多寻回犬:26.0 +/- 5.0°(Ragetly et al. 2011)

拉布拉多寻回犬:33.7 +/- 4.7°(Mostafa et al. 2018)

体重14至33 kg犬:31.3 +/- 6.2°(18至47°)(Montavon et al. 1985)

未成熟埃斯特雷拉山犬:29.9 +/- 4.8°(19至40°)(Ginja et al. 2006)

第二种方法采用轴位X线摄影或CT扫描所获得的股骨多平面重建图像。

X线摄影评估时,肢体摆放使股骨长轴垂直于检查台面并平行于X线束。整个股骨均需显示,包括股骨头股骨颈内侧髁外侧髁,股骨体在影像上呈同心环状。在透视引导下可确认体位摆放,并沿股骨长轴获得远近轴位X线投照图像。

CT评估时,通过逐层滚动横断面图像,选取能将整个股骨体显示为直圆柱体的横断面。

股骨颈前倾角为股骨髁间横轴股骨颈轴之间的夹角。

已发表的不同犬品种CT扫描股骨颈前倾角数值如下:

多品种混合:19.6 +/- 7.9°(Dudley et al. 2006)

多品种混合:26.86 +/- 11.46°(Kara et al. 2018)

玩具贵宾犬:19.8 +/- 4.6°(Yasukawa et al. 2016)

英国斗牛犬:11.4 +/- 6.4°(Lusetti et al. 2016)

英国斯塔福德郡斗牛梗:26.0 +/- 3.4°(Newman and Voss 2017)

吉娃娃:29.2 +/- 6.3°(Phetkaew et al. 2018)

未成熟埃斯特雷拉山犬:30.4 +/- 4.2°(20至41°)CT扫描(Ginja et al. 2006)

參考資料

  • Dudley RM, Kowaleski MP, Drost WT, Dyce J. Radiographic and computed tomographic determination of femoral varus and torsion in the dog. Vet Radiol Ultrasound. 2006 Oct-Nov;47(6):546-52. doi: 10.1111/j.1740-8261.2006.00184.x.

  • Ginja et al. (2007). Measurement of the femoral neck anteversion angle in the dog using computed tomography.174(2), 378–383. doi:10.1016/j.tvjl.2006.08.002

  • Kara ME, Sevil-Kilimci F, Dilek ÖG, Onar V. Proximal and distal alignment of normal canine femurs: A morphometric analysis. Ann Anat. 2018 May;217:125-128. doi: 10.1016/j.aanat.2018.02.006. Epub 2018 Mar 19

  • Lusetti F, Bonardi A, Eid C, Brandstetter de Belesini A, Martini FM. Pelvic limb alignment measured by computed tomography in purebred English Bulldogs with medial patellar luxation. Vet Comp Orthop Traumatol. 2017 May 10;30(3):200-208. doi: 10.3415/VCOT-16-07-0116. Epub 2017 May 5.

  • Montavon PM, ; Hohn RB, Olmstead ML, Rudy RL. Inclination and Anteversion Angles of the Femoral Head and Neck in the Dog Evaluation of a Standard Method of Measurement. Vet Surg. 1985 14(4), 277–82. doi:10.1111/j.1532-950x.1985.tb00883.x

  • Mostafa AA, Cunningham DP, Boudrieau RJ, Kowaleski MP, Griffon DJ. Influence of radiographic techniques on the measurement of femoral anteversion angles and a conformation score of pelvic limbs in Labrador retrievers. Vet Surg. 2018 Apr;47(3):421-430. doi: 10.1111/vsu.12782. Epub 2018 Mar 12.

  • Newman M, Voss K. Computed tomographic evaluation of femoral and tibial conformation in English Staffordshire Bull Terriers with and without congenital medial patellar luxation. Vet Comp Orthop Traumatol. 2017 May 22;30(3):191-199. doi: 10.3415/VCOT-16-12-0162. Epub 2017 Mar 23. Erratum in: Vet Comp Orthop Traumatol. 2017 Jul 10;30(4)

  • Phetkaew T, Kalpravidh M, Penchome R, Wangdee C. A Comparison of Angular Values of the Pelvic Limb with Normal and Medial Patellar Luxation Stifles in Chihuahua Dogs Using Radiography and Computed Tomography. Vet Comp Orthop Traumatol. 2018 Feb;31(2):114-123. doi: 10.3415/VCOT-17-05-0067. Epub 2018 Mar 13. Erratum in: Vet Comp Orthop Traumatol. 2018 Feb;31(2):a1.

  • Ragetly CA, Evans R, Mostafa AA, Griffon DJ. Multivariate analysis of morphometric characteristics to evaluate risk factors for cranial cruciate ligament deficiency in Labrador retrievers. Vet Surg. 2011 Apr;40(3):327-33. doi: 10.1111/j.1532-950X.2010.00787.x. Epub 2011 Feb 11.

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