2D与4D超声检测婴儿髋关节临床研究  

Application of 2D and 4D ultrasound for the scanning of hip in 58 infants

作　　者：涂长玉 赵亮[2] 

机构地区：[1]临沂市妇幼保健院超声科,山东省276001 [2]临沂市中医医院骨二科

出　　处：《中华临床医师杂志（电子版）》2011年第24期7295-7298,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过运用2D与4D超声对婴儿髋关节进行检查,重点观察婴儿髋臼骨顶形态在4D超声图像中的变化情况,评价4D超声对婴儿髋关节的诊断价值。方法随机对58例婴儿的双侧髋关节进行2D超声检查定位,再采用4D超声检查。其中,男34例,女24例,年龄最小1d,最大3个月。所有受检者均检查双侧髋关节,在2D超声检查的基础上,进行4D超声检查。根据髋臼骨顶的4D超声图像形态,将髋关节分为优、良、差三个级别。结果共获得116张2D髋关节超声图像,获得114张4D髋关节超声图像,其中,1个Ⅰb型和1个Ⅱa型髋关节,因小儿哭闹躁动而无法获得4D图像。在114张4D髋关节超声图像中,74个髋关节为优,其中Ⅰa型5个,Ⅰb型40个,Ⅱa型29个;38个髋关节为良,其中Ⅰb型15个,Ⅱa型22个,D型1个;2个髋关节为差,其中Ⅰb型1个,Ⅲ型1个。所有优级的髋关节中不含有D型、Ⅲ型髋关节。结论应用4D超声检查,可以弥补2D超声扫描中无法获得的髋臼骨顶部立体形态图像,通过对髋关节立体空间的显示,更加直观地评价髋臼的发育状况,从而对发育性髋关节脱位(DDH)作出更为可靠的诊断。婴儿髋关节4D超声检查是一种很有发展前途的技术,如果结合2D超声检查,将对DDH的诊断以及治疗中的随访观察发挥其独特的价值。Objective To evaluate the diagnostic value of 4D ultrasound in infant hip and observe the shape of acetabular bone roof of infant hip carefully.Methods The 4D sonographic scannning were undertaken randomly in both left and right hips for 58 infants.There were 34 males and 24 females.The age at the examination ranged from 1 d to 3 months.After performed with 2D ultrasonic scanning examination in all the infants,and then performed with 4D ultrasonic scanning examination.We divided 4D sonograms into three levels with acetabular bony roof shape:excellent,good and poor.Results We obtained 116 2D sonograms.For two infants couldn't cooperate,so we obtained 114 4D sonograms in final.In these 114 hips,there were 74 hips were excellent,in which there were 5 hips of Ⅰa type,40 hips of Ⅰb type and 29 hips of Ⅱa type.There were 38 hips were good,in which there were 15 hips of Ⅰb type,22 hips of Ⅱa type and one hip of D type.There were only two hips were poor,in which there were one hip of Ⅰb type and one hip of Ⅲ type.There were none of D type hip and Ⅲtype hip were excellent.Conclusions By using 4D ultrasound,we can obtain the shape of bone roof of acetabular which can not be obtained with 2D ultrasound,4D ultrasound can vividly demonstrate the shape of the hip,and more visually oriented to evaluate development of hip,and to make more reliable diagnosis of DDH.4D ultrasound is a promising technology,if combined with 2D ultrasound,it will play its unique value in diagnosis and treatment of DDH.

关 键 词：超声检查 髋关节 婴儿 髋脱位 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.8[医药卫生—诊断学]