Pemberton手术前后股骨头覆盖率的计算机图像分析

The Computer Images Analysis of The Femoral Head Coverage Rate Before and After Pemberton Operation

目的：通过CT扫描的计算机软件处理图像结合髋关节三维重建影像观察。以评价Pemberton术对小儿髋臼发育不良的手术治疗效果，为临床治疗提供客观的依据。方法：收集2003年10月～2005年10月，在我院小儿骨科经Pemberton手术治疗的髋臼发育不良的患儿20例。在螺旋CT工作站。对骨盆及股骨近端进行三维表面重建。在三维图像上，定性观察。测量Pemberton手术前后髋臼对股骨头覆盖面积的量化值，用SPSS11．5软件进行统计分析。结果：患儿术前、术后髋关节覆盖率数据结果分析：（n=35）术前髋臼对股骨头的平均覆盖率为33．8％，术后为82．0％。术前、术后比较有显著性差异（P〈0．01）。表明术后髋臼对股骨头的覆盖量明显增加。。其中，术前髋臼对股骨头前外侧平均覆盖率为2．6％，术后为21．2％。术前髋臼对股骨头后外侧平均覆盖率为2．2％，术后为15．9％。二者的术前、术后比较有显著性差异（P〈0．01）。术前髋臼对股骨头前内侧平均覆盖率为16．9％，术后为23．2％。术前髋臼对股骨头后内侧平均覆盖率为17．2％，术后24．0％。二者的术前、术后比较有显著性差异（P〈0．01）。结论：①通过CT扫描分析及其三维重建能较精确地评估出髋臼发育不良时股骨头覆盖不足的部位及缺损量的多少。②Pemberton术可明显增加股骨头的覆盖率，为治疗DDH有效的手术方法之一。③Pemberton手术后，多数髋关节经过再塑形过程。影像学上形态明显改善。

Objective： To evaluate the therapeutic efficacy of the Pemberton Osteotomy by 3DCT and image processing software in order to search for an effective method to deal with developmental dislocation of hip （DDH）. Methods： 20 children with developmental dislocation of hip treated by Pemberton Osteotomy , we used 3DCT to reconstruct the imagination of hips and measured the coverage rate of femoral head , then the data was analyzed with SPSS 11.5 . Results： The coverage rate of femoral head before and after operation （n = 35） ： the average coverage rate of femoral head before operation is 33.8 % , and this index is 82.0 % after Pemberton Osteotomy , and the difference was significant （P 〈0.01）. The average coverage rate of anterolateral before operation is 2.6 % , and 21.2 % after operation ; The average coverage rate of posterolateral before operation is 2.2 %, and 15.9 % after operation , and the difference was significant （P〈0.01）. The average coverage rate of anteromedial before operation is 16.9 % , and 23.2 % after operation ; The average coverage rate of posteromedial before operation is 17.2 % , and 24.0 % after operation , and the difference was significant （P 〈 0.01）. Conclusion： ①We can accurately evaluate the location and the degree of pathological hips by 3DCT . ②The coverage of femoral head can be significantly increased by Pemberton Osteotomy, so it is one of effective methods to treat DDH. ③Through this operation , most hips have been reconstructed , and radiological recovery was significant.