坐标系对齐对与手术规划相关的基于CT的桡骨远端形态测量学的影响：一项双侧对比研究

摘要(中文译文)

基于计算机断层扫描的三维形态计量分析越来越多地用于桡骨远端手术的手术规划和健侧模板制作。然而，坐标系对齐对形态计量测量的影响尚未得到系统评估。本研究采用横断面影像学研究，使用83名健康越南成年人（166个桡骨远端）的CT三维模型。分别使用两种坐标系测量桡骨远端宽度和厚度：软件默认包围盒方向，以及与桡骨远端纵轴对齐的解剖轴校正系统。采用配对分析比较测量值，并使用组内相关系数评估观察者间信度。两种坐标系之间的宽度测量无统计学显著差异。相比之下，解剖轴校正后厚度测量值 consistently 更大，右侧中位差异为0.18 mm，左侧为0.15 mm（均p < 0.001）。所有测量的观察者间信度均极佳（ICC = 1.0），反映了标准化坐标对齐工作流程的高可重复性。解剖坐标系对齐在基于CT的桡骨远端形态计量测量中引入微小但一致的差异，尤其是厚度估计。尽管绝对差异较小，但标准化坐标系对齐可能提高用于形态计量分析、术前规划和健侧模板制作的CT衍生测量的可重复性和可比性。未来的CT形态计量研究应明确描述用于测量的坐标系。

Abstract

Computed tomography-based three-dimensional morphometric analysis is increasingly used for surgical planning and contralateral templating in distal radius surgery. However, the influence of coordinate system alignment on morphometric measurements has not been systematically evaluated. A cross-sectional imaging study was performed using CT-derived three-dimensional models from 83 healthy Vietnamese adults (166 distal radii). Distal radius width and thickness were measured using two coordinate systems: the default software bounding-box orientation and an anatomically axis-corrected system aligned with the distal radius longitudinal axis. Measurements were compared using paired analyses, and inter-observer reliability was assessed using intraclass correlation coefficients. Width measurements showed no statistically significant differences between the two coordinate systems. In contrast, thickness measurements were consistently greater after anatomical axis correction, with median differences of 0.18 mm on the right and 0.15 mm on the left (both p < 0.001). Inter-observer reliability was excellent for all measurements (ICC = 1.0), reflecting the high reproducibility of the standardized coordinate alignment workflow. Anatomical coordinate system alignment introduces small but consistent differences in CT-based distal radius morphometric measurements, particularly for thickness estimation. Although the absolute differences were small, standardizing coordinate system alignment may improve the reproducibility and comparability of CT-derived measurements used for morphometric analysis, preoperative planning, and contralateral templating. Future CT-based morphometric studies should explicitly describe the coordinate system used for measurement.

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