小儿髋关节发育不良的CT应用价值  

CT Usage in Children with Developmental Displasia of Hip

作　　者：王秋艳[1] 沈斌[1] 李玉华[1] 张青[1] 陈博昌[1] 

机构地区：[1]上海第二医科大学附属新华医院放射科

出　　处：《临床放射学杂志》1998年第3期171-173,共3页Journal of Clinical Radiology

摘　　要：目的：探讨ＣＴ在小儿髋关节发育不良（ＤＤＨ）中的应用价值及方法。材料与方法：１９９６年至今经临床和Ｘ线诊断为ＤＤＨ的患儿４０例行ＣＴ扫描。男性３例，女性３７例。男女之比约１∶１２。年龄５个月～９岁，平均３．１岁。采用特制的足板和检查鞋，行髋臼、股骨头及股骨髁ＣＴ扫描。在软组织窗位和骨窗位观察髋臼及股骨头的发育，并进行股骨颈前倾角的测量。结果：完全性脱位２８例，占７０％，不完全性脱位１２例，占３０％。表现为髋臼、股骨头发育不良，髋关节间隙增宽、空虚，患侧髋关节腔内脂肪密度影填充５８侧（１００％）。３３例显示髂腰肌肌腱内陷，关节囊折叠，占５７％。其中以完全性脱位者为主（２４／３３）。股骨颈前倾角明显增大。结论：ＣＴ的横断面及高分辨率特性使之为临床ＤＤＨ的诊治提供了大量宝贵的信息。Objective: To investigate the value of CT usage in developmental dysplasia of hip (DDH) in clildren.Materials and Methods:40 cases of DDH diagnosed by clinics and plain films were performed with CT scan, 3 were males and 37 were females. Age from 5 month to 9 years old, average 3.1 years. Using specialized footboard and examining shoes, scan the acetabula, femoral heads and femoral condyles. Observe the development of acetabulum and femoral head in soft tissue windows and bone windows. Measure the femoral neck anterversion angles (FNAA).Results:There are 28 cases (70%) of completed dislocation, 12 cases (30%) of uncompleted dislocation. In CT films, development of acetabulum and femoral head were unsufficient and hip joint spaces were widen or emptied. The affected hip joint spaces were filled by fatty tissues. In all 40 cases 58 affected hip joint, 33 hip joints show iliopsoas muscle sunk between acetabulum and femoral head, causing capsule infold, about 57%, mainly in completed dislocation cases, 24/33. FNAA enlarged notably.Conclusion: Transversal scanning and high spacial CT make it possible to provide great amount of valuable information for clinical diagnosis and treatment in DDH, and also provide the objective means for the observing the curative effect after closed reduction and followup of operated patients.

关 键 词：髋关节发育不良 儿童 CT 髋关节脱位 先天性 

分 类 号：R726.821.7[医药卫生—儿科] R816.8[医药卫生—临床医学]