先天性髋关节脱位髋臼软骨的影像学研究

Imaging Study of Acetabular Cartilage in Congenital Dislocation of Hip

目的：研究先天性髋关节脱位骨性髋臼上缘异常形态的形成原因和髋臼软骨形态学变化对其产生的影响。方法：对６０例３岁以下先天性髋脱位患儿，７０髋分别行骨盆Ｘ线片和磁共振表现对比观察。结果：在７０髋脱位髋关节中，发现４６髋髋臼上缘不同程度的局限性凹痕、陡直及圆钝表现。经磁共振检查发现，有４２髋亦有骨性缺陷（χ２＝３１．３９，Ｐ＜０．０１）。有５３髋髋臼软骨变形、增厚及移位。其中，相应部位的髂骨骨壁，在绝大多数病例中出现病理形态学改变：髋臼软骨与Ｘ线片骨臼上缘异常的统计学检验为，χ２＝３２．２５，Ｐ＜０．０１；髋臼软骨与磁共振髂骨改变的统计学检验为，χ２＝３０．４６，Ｐ＜０．０１。结论：髋臼骨性外缘发育较差的病理基础是，髋臼软骨在髋脱位时产生了一系列继发性病理改变，导致局部骨臼外缘的发育障碍。该类型病例应尽早进行治疗，否则很可能发生继发性髋臼发育不良。

Objective: To investigate the etiology of abnormal morphology of acetabulum outer margin in congential dislocation of hip (CDH) by MRI. Methods: Seventy hips in 60 patients under 3 years of age were studied with Xrays and MRI. Results: Fortysix hips out of 70 were found to have local concavities, slanting or blunting of the acetabular margin whereas bony defects were detected in 42 hips with MRI (χ2=31.39, P<0.01)。 53 acetabular cartilage were deformed. thickened or dislocated. Parts of ileum morphology were also found to be abnormal. Conclusions: The abnormal bony outer margin of acetabulum of CDH is the result of ongoing pathological changes of the acetabular cartilage. These patients should be received immediate medical attention before acetabular dysplasia develop.