发育性髋关节脱位髋臼形态的MRI研究  

Acetabular morphology in children with developmental dysplasia of the hip by MRI

作　　者：陈帅[1] 王克来[1] 庄岩[1] 曲宏懿 

机构地区：[1]山东大学齐鲁医院小儿科,济南250012 [2]附属千佛山医院小儿科,济南250014

出　　处：《山东大学学报（医学版）》2011年第8期144-147,152,共5页Journal of Shandong University:Health Sciences

摘　　要：目的通过对发育性髋关节脱位患儿患侧髋臼与正常侧髋臼磁共振成像(MRI)表现的观察,探究发育性髋关节脱位患儿髋臼的病理改变。方法对12例发育性髋关节脱位的患儿进行髋关节MRI检查,其中单侧脱位8例,双侧脱位4例,共8个正常髋关节(对照组)、16个脱位髋关节(病变组)。测量双侧髋关节骨性髋臼指数(BA I)、软骨性髋臼指数(CA I)、骨性髋臼前倾角(BAAV)及软骨性前倾角(CAAV),对所得结果进行统计学分析。结果 BAI与CAI之间存在相关性,对照组两指数间相关系数(0.945)高于病变组的相关系数(0.814)。病变组BAAV与CAAV均明显大于对照组(P<0.01),病变组髋关节的CAAV明显大于BAAV(P<0.01)。所有髋关节BA I与BAAV、CAI与CAAV之间均存在相关性(相关系数分别为0.884和0.822)。结论发育性髋关节脱位的髋臼病理改变不仅体现在髋臼指数的改变,还体现在髋臼朝向的改变,这两种改变的程度存在着相关性。发育性髋关节脱位髋臼形态的畸形不仅体现在骨性结构,还体现在软骨结构上。两种结构的病理变化并不是完全同步的。采用MRI成像对DDH患儿的软骨结构进行评估可用于指导DDH的术式选择和手术操作。Objective To investigate pathological changes of the acetabulum by observing magnetic resonance imaging （MRI） of normal and dislocated hips in children with developmental dysplasia of the hip （DDH）. Methods 12 children with DDH（8 unilateral and 4 bilateral dislocated ones） had MRI of acetabulum, and 8 normal and 16 abnormal hips were observed. Acetabular indexes of bone （BAI） and cartilage （CAI） were measured on the coronal sections, and acetabular anteversion indexes of bone （BAAV） and cartilage （CAAV）were measured on the cross sections. The data were statistically analyzed. Results There was a correlation between BAI and CAI, and the correlation coefficient of normal hips （0. 945 ） was larger than that of abnormal hips （0.814）. Differences in BAAV and CAAV between dis- located and normal groups were significant（ P 〈 0.01 ）, and CAAV of abnormal hips was larger than their BAAV（ P 〈 0.01 ）. There were correlations between BAI and BAAV, as well as between CAI and CAAV, and corresponding cor- relation coefficients were 0. 884 and 0. 822, respectively. Conclusion Pathological changes of the acetabulum in chil- dren with DDH are reflected not only in the acetabular index but also in the direction of acetabulum, and there is a correlation between these two changes. Deformity of the acetabulum is reflected in two aspects-bone and cartilage, which have different degrees of deformity. MRI can be used to evaluate deformity of the cartilage before operation, which is helpful for choosing operative methods and guiding the surgical process.

关 键 词：发育性髋关节脱位 磁共振 髋臼前倾 骨性髋臼指数 软骨性髋臼指数 

分 类 号：R726.8[医药卫生—儿科]