螺旋CT对发育性髋关节脱位中髋臼的形态学研究

Spiral CT imaging study of acetabular morphology in developmental dysplasia of hip

目的 利用螺旋CT三维成像进行髋臼形态学观察和三维髋臼指数测量,探讨发育性髋关节脱位中髋臼形态学改变的特点。 方法 对47例61髋进行三维CT观察,采用表面遮盖显示技术(SSD)研究髋臼的形态和缺损的类型并测量三维髋臼指数。 结果 轴位上7个半脱位髋臼圆弧形基本存在,深度稍变浅;54个全脱位的髋臼呈三角形或类三角形改变,其深度变浅;61个髋臼的三维CT显示髋臼缺损类型包括轻微缺损9髋(14.7％)、前上缺损17髋(27.9％)、中上缺损30髋(49.2％)、全缺损5髋(8.2％),髋臼缺损部位与股骨头脱位密切相关。上髋臼指数的改变程度明显大于前、后髋臼指数的改变,即上髋臼指数明显大于正常(P<0.01)。 结论 三维CT能够更好地反映髋臼的形态,确定髋臼缺损的类型,在手术方案制定中有着重要的价值。

Objective To discuss the characterized morphologic changes of acetabulum in developmental dysplasia of the hip (DDH) by studying the acetebular morphology and measuring the three dimensional acetabulum indices. Methods The morphology, classification, acetebular index in 47 cases with DDH (61 hips) were studied by spiral CT scan with shaded surface display (SSD). Results In 54 complete dislocations, the shape of acetabulum was similar to a triangle;it tended to be normal in 7 semiluxations. Among 61 hips of DDH,there were 9 mild defects (14.7%), 17 anterior-superior defects (27.9%),30 superior-median defects (49.2%) and 5 complete defects (8.2%).There existed a correlation between the defects and dislocation of femoral head.The change of superior acetebular index was greater than that of anterior and posterior acetebular index. Conclusion 3DCT scan,best manifesting acetebular morphology and determining the type of acetabular defects, is of great clinical value on proposing the design of surgical procedures.