螺旋CT三维重建在儿童发育性髋关节脱位治疗中的应用  

Three-dimensional CT imaging in the treatment of children's developmental dislocation of hip

作　　者：姜海[1] 苗武胜[1] 袁会军[2] 余建国[2] 

机构地区：[1]西安市红十字会医院儿骨科,陕西西安710054 [2]西安市红十字会医院影像科

出　　处：《中国骨伤》2009年第6期460-462,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:通过术前术后对髋关节前倾角及髋臼壁发育情况的观察,探讨螺旋CT三维重建技术在儿童发育性髋关节脱位(DDH)治疗中的应用价值。方法:2003年6月至2007年6月,发育性髋关节脱位53例(61髋),男12例,女41例;左侧34例,右侧11例,双侧8例;年龄3～16岁,平均5.6岁。行双侧髋关节螺旋CT三维重建检查,测量前倾角(FNA)及髋臼壁的发育情况,与术中所见比较。采用Pemberton或Chiari骨盆截骨及股骨近端旋转截骨治疗,术后复查三维CT,测量FNA,观察新髋臼的情况,与术前进行比较。结果:53例患髋前倾角均增大,最大90°,最小35°,平均(45.6±11.4)°。正常45髋前倾角为(23.5±10.2)°。髋臼各壁不同程度发育不良,与术中所见符合。术后前倾角较术前明显降低,前倾角平均(15.6±5.8)°。髋臼对股骨头包容明显改善。结论:髋关节螺旋CT三维重建技术可以全面显示髋关节的病理形态,精确地测量FNA,对术者选择适当的治疗方案具有重要的指导意义,术后能更直观地判断手术效果,评估预后。Objective ：To investigate the value of 3-dimensional CT in the treatment of developmental dislocation of hip （DDH）. Methods：From 2003.6 to 2007.6, the femoral neck anteversion （FNA） and morphology of acetebnlum in 53 patients with DDH（61 hips） were studied by three-dimensional CT imaging. Among the patients, 12 patients were male and 41 patients were female, ranging in age from 3 to 16 years （mean 5.6 years）. Thirty-four patients had dislocation in left hip joint, 11 patients had dislocation in right hip joints,and 8 patients had double dislocations. The patients were treated with Pemberton or Chiari acetabuloplasty and femoral osteotomy, After operation all the cases were obeserved by 3-dimensional CT again. The femoral neck anteversions were measured and the shapes of new acetabnlum were observed. Results：Among 61 hips of DDH, the maximum femoral neck anteversion was 90°. The minimum was 35°and the average was （45.6±11.4）°. Among 45 normal hips, the average femoral neck anteversion was （23.5±10. 2 ）°. The acetabulum were dysplastic according with what were found in the operation. After operation the femoral neck anteversions decreased and averaged （15.6±5.8）°. The femoral head containment improved. Conclusion：The advantages of 3D CT scan includes manifestation of acetebular morphology,correct measurement of femoral neck anteversion and evaluation of operative procedure and efficacy. The 3-dimensional CT method is deserved to use widely in the treatment of developmental dislocation of hip in children.

关 键 词：髋脱位 儿童 体层摄影术 螺旋计算机 髋臼 

分 类 号：R782.4[医药卫生—口腔医学] R684.7[医药卫生—临床医学]