摘要
目的 通过多层螺旋CT三维成像进行髋臼形态学的观察和三维髋臼指数的测量 ,探讨其在发育性髋关节脱位术前、术后的应用价值。方法 对 4 2例 5 6髋进行三维CT观察 ,采用表面遮盖显示技术 (SSD) ,研究髋臼缺损的类型并测量髋臼的三维髋臼指数。 2 6髋采用带骨膜及软骨的髂骨移植髋臼成形术治疗 ,探讨手术方式的选择及术前术后的评价。结果 5 6个髋臼的 3DCT显示髋臼缺损类型包括轻微缺损 11髋 (19.6 % )、中上缺损 2 6髋 (4 6 .4 % )、前上缺损 14髋 (2 5 .0 % )、全缺损 5髋 (8.9% )。缺损类型与Dunn分型之间无明显相关关系 (r =0 .2 1)。术前 ,上髋臼指数的变化比前、后髋臼指数的变化明显 ,髋臼上下径与髋臼前后径之比大于 1,髋臼形态呈椭圆形。其中 ,中上缺损 2 6髋采用带骨膜及软骨的髂骨移植髋臼成形术治疗 ,术后随访 6～ 18个月 ,3DCT显示髋臼缺损修复完整、髋臼形态趋于正常。结论 3DCT能够更好地反映髋臼的形态、确定髋臼缺损的类型 ,为手术方式的选择和术后疗效的评价提供客观依据。
Objective To investigate the value of 3 dimensional CT in studying the acetebular morphology of developmental dysplasia of hip (DDH) pre and postoperatively.Methods The morphology, classification, acetebular index and the ratio of diameter of superior inferior and anterior posterior of acetebulum in 42 cases (male 11, female 31) with DDH (56 hips) were studied by X ray film, CT scan (Marconi Multiplayer Spiral Scan) with shaded surface display (SSD or 3 D). The age ranged from 2～14 years (mean 4.5 years). There were unilateral DDH in 28 cases and bilateral in 14 cases.Results Among 56 hips of DDH, the defect included mild in 11 hips ( 19.6% ), superior median defect in 26 ( 46.4% ), anterior median defect in 14 (25%) and total defect in 5 ( 8.9% ) .There were no correlation between the defects and Dunn's classification ( r = 0.21 ).The 3 DCT of 26 hips that underwent acetabuloplasty with ilium graft showed the acetabulum shape restored to normal in results with a followed up period from 6 to 18 months.Conclusion The advantages of three DCT scan are best manifestation of acetebular morphology,confirmation of the classification and evaluation of operative procedure and efficacy.
出处
《中华小儿外科杂志》
CSCD
北大核心
2003年第3期208-210,共3页
Chinese Journal of Pediatric Surgery
