三维CT重建对先天性髋关节脱位的诊断价值

Three-dimensional CT in the diagnosis of congenital dislocation of hip

目的 探讨三维 CT重建在先天性髋关节脱位(CDH)的临床应用 .方法 本组 CDH患儿 2 2例 ,其中双髋脱位 1 5例 ,单髋脱位 7例 ,另有正常髋 2例 ,共计患髋 37个 ,正常对照髋 1 1个 .采用 Picker公司 PQ60 0 0螺旋 CT机 ,在独立工作站进行表面遮盖成像 (SSD)、最大密度投影 (MIP)、多平面重建 (MPR)和相关数据测量 .结果 分别对股骨头颈、髋臼及头臼关系行三维直观显示 ,运用 MPR技术测量了髋臼指数 (AI)和股骨颈前倾角 (FNA ) :AI正常组平均值(1 7.6± 4.8)°,异常组平均值 (35.4± 9.5)°,FNA正常组平均值 (2 2 .5± 7.1 )°,异常组平均值 (38.0± 1 0 .7)°.结论 三维CT可以直观、全面及分解地显示髋关节结构 ,对于股骨头、髋臼形态和头臼关系的显示以及精确的相关测量具有优势 。

AIM To evaluate the clinical application and importance of the reconstruction of three dimensional (3D) CT on congenital dislocation of hip joint (CDH). METHODS There were 22 patients with the diagnosis of CDH in this pro ject, including 15 bilateral involvements and 7 unilateral involvements as well as two normal hips. In total, there were 37 dislocated hips and 11 hips for control. The patients were examined with spiral CT (PQ 6000, Picker Co.). The 3D pictures were taken and the relevant measurements were made in terms of SSD, MIP and MPR on an independent computer workstation. RESULTS The 3D reconstruction techniques were successfully used to show femoral head, acetabulum and the relationship between acetabulum and femoral head respectively. The technique of MPR was used to measure the acetabular index (AI) and femoral neck anteversion (FNA). The average value of AI was (17.6±4.8)° in normal group and (35.4±9.5)° in abnormal group. The average value of FNA was (22.5±7.1)° in normal group and (38.0±10.7)° in abnormal group. CONCLUSION The 3D CT of hip joint provides precise information of the imaging and is a very useful technique for the diagnosis and treatment planning of CDH.