螺旋CT三维重建在DDH患儿髋关节形态、结构观测中的应用

Application of spiral CT three-dimensional reconstruction on developmental dislocation of the hip (DDH) in children

目的探讨螺旋CT三维重建技术在发育性髋关节脱位(DDH)患儿髋关节形态、结构观测中的应用价值。方法随机选取30例单侧DDH患儿,对其髋关节进行螺旋CT三维重建。观察髋关节形态,分别测量髋臼的横径(D)和纵径(H),计算髋臼表面积。测量双侧髋臼的深度(AD),计算髋臼的容积。同时测定股骨头表面容积并计算髋臼深度/股骨头直径(AD/FHD)值。结果患侧髋关节髋臼上缘前上方缺陷10例,中上方缺陷12例,环形缺陷8例。半脱位患儿以髋臼上缘前上方缺陷为主,髋臼前方发育差,髋臼轻度前倾;全脱位患儿整个髋臼发育浅。髋臼表面积健侧为(26.23±1.26)mm2,患侧为(22.14±2.49)mm2;AD健侧为(25.12±1.28)mm,患侧为(22.34±1.76)mm;髋臼容积健侧为(216.66±9.12)mm3,患侧为(161.33±6.47)mm3;股骨头表面容积健侧为(203.12±7.44)mm3,患侧为(162.12±5.27)mm3;AD/FHD健侧为(1.12±0.76),患侧为(0.85±0.49)。以上指标两侧比较差异均有统计学意义(P<0.05)。健侧髋臼容积与股骨头表面容积呈正相关(r=0.392,P<0.05)。结论利用螺旋CT三维重建技术可直观、准确地观测DDH患儿髋关节的形态和结构,有利于指导DDH的手术治疗。

[Objective] To evaluate the role of spinal CT three-demensional reconstruction in the operative treatment of DDH. [Methods] 30 unilateral DDH children were randomly selected ,and their hip joints sipnal CT imagines were reconstructed. The parameters demonstrating the shape and size of the acetabulum were measured With 3-DCT： superior-inferior diameter（H）,anterior-posterior diameter（D） of acetabulum, and acetabular depth （AD）. The acetabulum surface area, the acetabulum volume and the femoral head surface volume of the affected hip joint and the normal hip joint were calculated. The femoral head diameter（FHD） was measured. [Results] There were 10 cas.es anterior-superior defect~ 12 cases middle-superior defect; 8 cases ring-like defect. The surface area of the affected hip with dislocation and the normal one was （22.14 ± 2.49） mm^2 and （26.23±1.26） mm^2 AD was （22. 34 ±1.76） mm and （25. 12±1.28） mm respectively ; The acetabulum volume was （161.33 ± 6.47） mm^3 and （216. 66±9. 12） mm^3 ;The femoral head surface volume was（162. 12±5.27） mm^3 and （203. 12±7.44） mm^3;; AD/FHD was （1.12 ± 0.76 ） and （0. 85± 0. 49）, All the differences between two sides were significant, P 〈0. 05. The acetabulum wlume had positive correlation with the femoral head surface volume. The correlation coefficient between the values of the acetabulum volume and the femoral head surface volume of the normal hip was 0. 392, P 〈0. 05. [Conclusions] 3-DCT is an effective method for obsening the acetabular bony deficiency and pattern in DDH.