基于CT三维重建的肩胛切迹解剖分型及临床意义

目的 探讨基于CT三维重建的肩胛切迹解剖形态学分型及临床意义。 方法 收集来自西南医科大学附属中医医院300例因肩部疾病就诊患者的肩胛骨，通过CT三维技术重建肩胛骨图像，并进行肩胛切迹形态学分型及几何数据测量。 结果 我们将收集的肩胛切迹分为5种类型,√-形称为Ⅰ型共138例，约占46%；U-形称为Ⅱ型共125例约占41.7%；Ⅴ-形称为Ⅲ型，共20例，约占6.7%；O-形称为Ⅳ型，共10例约占3.3%；Ω-形称为Ⅴ型，共7例约占2.3%（另外，发现W-形、双O-形各1例，因数量较少暂未纳入分型）；左侧肩胛切迹平均深度、宽度分别为（5.58±1.42、10.22±3.24）mm，右侧肩胛切迹平均深度、宽度分别为（6.02±1.87、10.81±3.35）mm，左右对比差异有统计学意义（P<0.05）；Ⅰ和Ⅱ型的切迹宽度较其他3种类型宽度更宽，分别为（12.46±3.20、9.95±2.68）mm，且P<0.05差异有统计学意义；另外，不同类型中肩胛切迹最低点到肩胛冈基底部的垂直距离长度有所不同，其中Ⅰ型最短的为（12.52±2.56）mm，Ⅲ型最长的为（14.48±4.29）mm，Ⅰ型和Ⅲ型比较差异有统计学意义（P<0.05）。 结论 基于CT三维重建结果，将肩胛切迹分为5型，分别为√-形、U-形、Ⅴ-形、O-形、Ω-形。其中Ⅴ-形和O-形发生肩胛上神经卡压症的几率较大，而√-形及U-形的卡压几率则较小。

Anatomical classification and clinical significance of scapular notch based on CT 3D reconstruction

Objective To research the anatomical classification of suprascapular notch based on CT 3D reconstruction and its clinical significance. Methods A total of 300 suprascapular (left 142, right 158) data were collected from Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University were measured based on CT 3D reconstruction. The suprascapular images were reconstructed by CT 3D technique, and the scapular morphological classification was made and geometric data were measured. Results Five types of suprascapular notch were found. Type Ⅰ(√, a total of 138 cases, 46%) was the most common, followed by type Ⅱ (U, a total of 125 cases, 41.7%), type Ⅲ(Ⅴ, a total of 20 cases, 6.7%), type Ⅳ(O, atotol of 10 cases, 3.3%) and type Ⅴ (Ω, a total of 7 cases, 2.3%), in addition, found W-shaped, double O-shaped each 1, because of the number was rare, it was not included in the classification. The average depth and width of the left suprascapular notch were (5.58±1.42) mm and (10.22±3.24) mm, and the right scapula were (6.02±1.87)mm and (10.81±3.35) mm, respectively(P<0.05). The width of the incision of type Ⅰ and type Ⅱ was wider than that of the other three types, which were (12.46±3.20)mm and (9.95±2.68)mm, and P<0.05. In addition, the length of the vertical point from the lowest point of the suprascapular notch to the base of the scapula was different. Type Ⅰ (the shortest) was about (12.52±2.56) mm, and type Ⅲ(the longest) was about (14.48±4.29) mm. There was a statistical difference between type Ⅰ and type Ⅲ (P<0.05). Conclusion Based on the result of CT three-dimensional reconstruction, the suprascapular notch is divided into five types, which are √-shaped, U-shaped, Ⅴ-shaped, O-shaped, and Ω-shaped. The probability of suprascapular nerve compression in Ⅴ-shaped and O-shaped is more, on the contrary, the shape of the √-shaped and U-shaped compression is small.