螺旋CT和三维重建技术在髋关节发育不良手术治疗中的应用

Spiral CT and three-dimensional reconstruction imaging in developmental dysplasia of hip

目的 探讨螺旋CT及三维重建技术在发育性髋关节发育不良手术治疗中的应用。方法 收集病例 1 6例 ,患儿术前均接受X线、CT扫描和三维CT重建检查。比较三者的检查结果 ,结合术中所见 ,评价螺旋CT及三维重建技术在发育性髋关节不良手术治疗中的作用。结果 对比 1 6例髋脱位X线及CT扫描 ,三维CT重建资料 ,其中 9例X线与CT扫描、三维重建检查结果一致。但三维重建有 2例髋臼前上方缺损 (Ⅱ型 ) ,4例中上方缺损 (Ⅲ型 ) ,1例球型缺损 (Ⅳ型 ) ,X线片仅表现为股骨头脱位和髋臼发育不良。因此这 7例患儿更改了依据X线表现拟定的手术治疗方案。 2例行Salter骨盆旋转截骨术 ,3例行改良莎氏手术 ,2例行改良莎氏手术 +髋臼造架手术 ,依靠螺旋CT及三维重建技术的资料 ,术前可以辅助诊断 ,对治疗具有指导意义。结论 螺旋CT及三维重建技术能多方位、立体地显示髋关节的形态 ,对术者选择适当的治疗方案及手术入路 。

Objective To study the role of three dimensional computed tomography and reconstruction (3 DCT) in the operative treatment of developmental dysplasia of the hip. Methods Twenty cases of developmental dysplasia of hip were examined preoperatively with X ray and 3 DCT. The 3 DCT data were compared with the operative findings.Results In 9 out of 16 cases, X ray and 3 DCT results were consistent with each other. For the remaining 7 cases, 3 DCT revealed deformities not shown on X ray and the operative plans were modified according to the findings.Conclusion 3 DCT provides a better image of hip dislocation and is helpful to decide the surgical approach and degree of correction.