摘要
目的 通过测量MRI三维髋臼指数 ,探讨幼儿发育性髋脱位髋臼病理形态改变的特点。方法 本文对 1993年 2月～ 1998年 4月我院治疗的 2 8例单侧发育性髋脱位幼儿采用MRI扫描系统 ,在经过正常侧股骨头中心的MRI冠状面上测量双髋的骨性和软骨性髋臼指数 ,横断面上测量骨性前髋臼指数、后髋臼指数 ,软骨性前髋臼指数、后髋臼指数。结果 脱位侧骨性三维髋臼指数较正常侧增大 ,但脱位侧冠状面软骨性髋臼指数较正常侧增大 ,横断面上软骨性前、后髋臼指数减小。正常侧骨性与软骨性三维髋臼指数间存在较大相关性。脱位侧髋关节在Dunn分型后 ,骨性与软骨性三维髋臼指数亦存在较大相关性。三维髋臼指数随Dunn脱位呈规律性改变 ,从DunnⅠ～Ⅲ型脱位 ,随着脱位股骨头位置的增高 ,骨性三维髋臼指数呈增大趋势 ;软骨性三维髋臼指数中冠状面软骨性髋臼指数逐渐增大 ,横断面软骨性前、后髋臼指数均逐渐减小。结论 ①幼儿发育性髋脱位髋臼的开口是椭圆形改变趋势 ,即骨性髋臼开口增大改变 ,冠状面上改变的幅度明显大于横断面 ;软骨性髋臼开口的改变是冠状面上开口变大 ,横断面上开口变小。②股骨头在髋臼内的存在是髋臼软骨保持正常形态的决定因素 ,髋臼软骨的病理增生改变与脱位后股骨头的位置密切相关 。
Objective To measure the three dimensional bony and cartilaginous acetabulum indices (TDBAI, TDCAI) and characterize pathological change in acetabulum of developmental dysplasia of the hip (DDH) in infants.Methods Using MRI,bilateral bony and cartilaginous acetabular indices (BAI,CAI,ABAI,PBAI,ACAI,PCAI) were measured. Results The TDBAI of the involved hips were greater than those of the normal hips. In TDCAI however,the CAI of the involved hips was greater than that of the normal hips. In addition,the ACAI and the PCAI of the involved hips were less than those of the normal hips.The correlation between the TDBAI and TDCAI on the normal side was statistically significant, so was that on the involved side when using Dunn classification.As for TDCAI of Dunn I to Dunn III,the CAI decreased gradually.Conclusions 1.The aperture of the acetabulum with DDH tends to metamorphose into an ellipsoid shape. 2.The femoral head docking with the acetabulum is a prerequisite for maintaining the acetabular cartilage shape. It is essential to reduce dislocated hips concentrically as early as possible so that the acetabulum can resume normal morphology and function.
出处
《中华小儿外科杂志》
CSCD
北大核心
2002年第1期43-46,共4页
Chinese Journal of Pediatric Surgery
