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. 2022 Jun 13:49:e20223130.
doi: 10.1590/0100-6991e-20223130-en. eCollection 2022.

Prospective study of the Iliac Bicrest Pubic Angle through the 3D reconstruction of the bone pelvis and the correlation with giant incisional hernia

[Article in English, Portuguese]
Carlos José Lazzarini Mendes  1   2 , Rodrigo Altenfelder Silva  1   2 , Marcelo DE Castro Jorge Racy  2 , Vinicius Castro DE Rezende Fiorot  2 , Sergio Roll  1   2 , Adhemar Monteiro Pacheco Junior  1   2
Affiliations

Prospective study of the Iliac Bicrest Pubic Angle through the 3D reconstruction of the bone pelvis and the correlation with giant incisional hernia

[Article in English, Portuguese]
Carlos José Lazzarini Mendes et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Objective: to describe and measure the Bicrista Iliaca Pubo Angle (APBCI) as a new anthropometric parameter. Correlate the measurement with patients with giant incisional hernia (HIG), in the midline of the anterior abdominal wall (AAW).

Methods: measurement of APBCI, through 3D reconstruction from computed tomography (CT). Measurements performed by two observers, R and C, in 246 women and 60 men, normal adults, in order to obtain the APBCI measurement and its correlation in patients with HIG of the AAW.

Results: after sample calculations, the measurement of APBCI in men: 92.5+6.3º to 93.8+6.7º; in women: 90+6.7° to 94.3+6.8° [p-value 0.337(R)/0.628(C)]. The mean age was 57.9+15.9 years (22 to 91 years). Female gender 57+15.7 years (22 to 91 years) and male 61.7+16.5 years (23 to 89 years) p=0.067. As for the distribution of the ranges from 5 to 5 degrees, there is no difference in the distribution of the angle [p-value 0.455(R)/0.672(C)]. The correlation between age and angle showed that the higher the age, the higher the APBCI. There was no variability between angle measurements: 0.97 (95% CI 0.97; 0.98). In men with HIG, the average is between 108.3+5.37º (102.92º to 113.67º), and in women, 107.8+6.64 (101.16º to 114.44º).

Conclusion: the study allowed us to conclude that HIG is not just an isolated AAW defect. Determines skeletal changes, as the APBCI is influenced by the distance of the iliac crests.

Objetivo:: descrever e medir o Ângulo Pubo Bicrista Iliaca (APBCI) como novo parâmetro antropométrico. Correlacionar a medida com portadores de hérnia incisional gigante (HIG), da linha média da parede anterior do abdome (PAA).

Métodos:: medida do APBCI, através de reconstrução 3D a partir de tomografia computadorizada (TC). Realização de medidas por dois observadores, R e C, em 246 mulheres e 60 homens, adultos normais, afim de obter a medida do APBCI e sua correlação em portadores de HIG da PAA.

Resultados:: após cálculos de amostra, a medida do APBCI nos homens: 92,5+6,3º a 93,8+6,7º; nas mulheres: 90+6,7º a 94,3+6,8º [p-valor 0,337(R)/0,628(C)]. A média de idade foi de 57,9+15,9 anos (22 a 91 anos). Gênero feminino 57+15,7 anos (22 a 91 anos) e o masculino 61,7+16,5 anos (23 a 89 anos) p=0,067. Quanto à distribuição das faixas de 5 em 5 graus, inexiste diferença na distribuição do ângulo [p-valor 0,455(R)/0,672(C)]. A correlação idade e o ângulo demonstrou que quanto maior a idade, maior o APBCI. Não houve variabilidade entre as medidas do ângulo: 0,97 (IC95% 0,97; 0,98). Nos homens com HIG, a média está entre 108,3+5,37º (102,92º a 113,67º), e nas mulheres 107,8+6,64 (101,16º a 114,44º).

Conclusão:: o estudo permitiu concluir que a HIG não é apenas um defeito da PAA isolado. Determina alterações esqueléticas, na medida que o APBCI sofre a influência quanto ao afastamento das cristas ilíacas.

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Conflict of interest statement

Conflict of interest: no.

Figures

Figure 1A
Figure 1A. Radojevic Angle.
Figure 1B
Figure 1B. Pelvis: IBCPA landmarks.
Figure 2
Figure 2. Right hemi-pelvis.
Figure 3
Figure 3. A. Pelvis, three-dimensional reconstruction 1. Red arrow shows Navigator Cube in anatomical position. B. Pelvis, three-dimensional reconstruction 2. Red arrow shows Navigator Cube in craniocaudal rotation position. Wrong position. C. three-dimensional reconstruction 3. Red arrow shows Navigator Cube in caudocranial rotation position. Wrong position.
Figure 4
Figure 4. A. A. Pelvis, three-dimensional reconstruction. Red arrow shows Navigator Cube in right side rotation position. Wrong position. B. Pelvis, three-dimensional reconstruction. Red arrow shows Navigator Cube in left lateral rotation position. Wrong position.
Figure 5
Figure 5. A. Image Import Screen - Osirix MD. B. Sequence selection screen: 1.0mm thick and 1.0mm increment - OSIRIX MD. C. Conversion screen for three-dimensional volume - “3D Volume Rendering” - OSIRIX MD .
Figure 6
Figure 6. A. Bone modality preset conversion screen - “Group Bone CT: glossy” - OSIRIX MD. B. Screen of image selected and manipulated with three-dimensional rotation for anatomical position. A: cube demonstrating 3D anatomical position - OSIRIX MD. C. Screen of DICOM format image export in for angle measurement - software opening screen - OSIRIX MD. D. Screen of image export for angle measurement - software opening screen with high quality (“Best redering”) - OSIRIX MD .
Figure 7
Figure 7. A. Screen of image exported for measurement of IBCPA - OSIRIX MD. B. “Angle” tool selection screen and first line drawing for angle measurement - OSIRIX MD. C. First IBCPA line drawing screen - OSIRIX MD .
Figure 8
Figure 8. A. Second IBCPA line drawing screen - OSIRIX MD. B. Screen of drawn and measured IBCPA - OSIRIX MD.
Chart 1
Chart 1. Distribution by age group.
See this image and copyright information in PMC

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