通过CT扫描揭示腹白线三维结构差异，为疝气风险评估提供新依据。
Linea alba 3D morphometric variability by CT scan exploration
- 基于117例CT数据，量化腹白线长度、曲率与宽度的三维变化
- 脐部最宽达4.4厘米，肥胖者曲率是正常组3倍，随年龄和体重增加而变宽
- 女性在脐与耻骨中段更宽，适合外科手术规划与病理研究
目的：腹白线宽度（常以腹直肌间距衡量）是切口疝及复发的关键风险因素。以往研究对宽度、位置变异性和曲率考虑不足。本研究旨在通过全面的3D解剖分析，揭示腹白线在不同人群中的变异特征。方法：利用开源软件对117例患者的CT扫描进行矢状面2D及3D重建，测量腹白线长度、曲率（以剑耻连线至腹白线最长垂直距离即矢状高表示）以及沿高度的连续宽度。结果：腹白线呈菱形，脐部最宽，平均4.4±1.9厘米，脐上宽度大于脐下。全长37.5±3.6厘米，随体重指数（BMI）增加而延长（p≤0.001），女性较短（p≤0.001）。矢状高为2.6±2.2厘米，肥胖者高出3倍（p≤0.001），随年龄增长而增加（p=0.009），但与性别无关（p=0.212）。宽度随年龄和BMI增加而增宽（p≤0.001，p=0.002），女性在脐耻中点处显著更宽（p=0.007）。结论：本研究提供了腹白线三维解剖变异的详尽描述，提出新的曲率指标。该方法可实现个体化解剖表征，未来需进一步验证其与疝气、腹直肌分离等病理的关系。
原文摘要 · Abstract (English)
Purpose: The width of the Linea alba, which is often gauged by inter-rectus distance, is a key risk factor for incisional hernia and recurrence. Previous studies provided limited descriptions with no consideration for width, location variability, or curvature. We aimed to offer a comprehensive 3D anatomical analysis of the Linea alba, emphasizing its variations across diverse demographics. Methods: Using open source software, 2D sagittal plane and 3D reconstructions were performed on 117 patients' CT scans. Linea alba length, curvature assessed by the sagitta (the longest perpendicular segment between xipho-pubic line and the Linea alba), and continuous width along the height were measured. Results: The Linea alba had a rhombus shape, with a maximum width at the umbilicus of 4.4$\pm$1.9 cm and a larger width above the umbilicus than below. Its length was 37.5$\pm$3.6 cm, which increased with body mass index (BMI) (p$\leq$0.001), and was shorter in women (p$\leq$0.001). The sagitta was 2.6$\pm$2.2 cm, three times higher in the obese group (p$\leq$0.001), majorated with age (p=0.009), but was independent of gender (p=0.212). Linea alba width increased with both age and BMI (p$\leq$0.001, p=0.002), being notably wider in women halfway between the umbilicus and pubis (p=0.007). Conclusion: This study provides an exhaustive 3D description of Linea alba's anatomical variability, presenting new considerations for curvature. This method provides a patient-specific anatomy description of the Linea alba. Further studies are needed to determine whether 3D reconstruction correlates with pathologies, such as hernias and diastasis recti.
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