三维CT在先天性髋关节脱位手术前后的应用

The Application of Three-dimensional CT in Congenital Dislocation of Hip Joint

目的 探讨三维CT在先天性髋关节脱位 (CDH)手术前后的临床应用价值。方法 本组CDH患儿 17例 ,其中双髋脱位 10例 ,单髋脱位 7例 ,共计手术髋 2 6个 ,未手术髋 8个。采用Picker公司PQ 60 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)等三维观察和相关数据测量。结果 分别于手术前后对股骨头颈、髋臼及臼头关系行三维直观显示 ,并测量髋臼指数 (AI)和股骨颈前倾角 (FNA)的变化。结论 三维CT可以直观、全面及分解地显示髋关节结构 ,更加精确地测量AI和FNA ,从而构成CDH诊治的新模式 :立体观察、三维测量。

Purpose To evaluate the applied value of the reconstruction of three dimentional CT on pre operation and post operation of congenital dislocation of hip joint(CDH). Methods Seventeen cases of CDH with 10 bilateral cases and 7 unilateral cases. To sum up, 26 sick hips were operated and 8 non operated hips were also obtained. The cases were examined by spiral CT (PQ6000,Picker Co),then the 3D pictures and relevant data measure were obtained by techniques of SSD, MIP and MPR on a workstation. Results 3D reconstruction were used to show femoral head, acetabulum and relationship of acetabulum and femoral head respectively. The technique of MPR was used to evaluate acetabulum index (AI) and femoral neck anteversion (FNA). The differences between pre and post operation were compared. Conclusion 3D CT of hip increases the information of imaging and affords the new technical support to related diagnosis and therapy of CDH. It will lead to a new model to deal with CDH: stereoscopic observation, three dimentional measurement and contraposed therapy.