髋臼发育不良患者髋臼周围截骨术前的三维CT测量  

Pre-periacetabular Osteotomy Three-dimensional CT Evaluation in Patients with Acetabular Dysplasia

作　　者：张雁伟[1,2] 程晓光[1,2] 吴志刚[1,2] 王予生[1,2] 及松洁[1,3] 

机构地区：[1]北京积水潭医院 [2]北京大学第四临床医学院放射科,北京100035 [3]北京大学第四临床医学院矫形骨科,北京100035

出　　处：《中国医学影像学杂志》2012年第5期339-342,共4页Chinese Journal of Medical Imaging

摘　　要：目的使用三维CT测量无晚期骨关节炎的髋臼发育不良患者的髋臼,并分析覆盖缺损类型和程度。资料与方法 30例患者共46个髋关节于髋臼周围截骨术前行X线片和三维CT扫描,分别测量外侧中心边缘角、臼顶倾斜角和前方中心边缘角,及三维CT上的髋臼前倾角、髋臼前角、髋臼后角。应用Harris评分对患者进行临床评估。结果三维CT和X线片测得的外侧中心边缘角、臼顶倾斜角和前方中心边缘角差异无统计学意义(P>0.05)。根据髋臼覆盖缺损部位分为外侧缺损(7个髋)、外侧+前方缺损(12个髋)、外侧+后方缺损(9个髋)和完全缺损(18个髋),4组前方中心边缘角、髋臼前倾角、髋臼前角和髋臼后角差异有统计学意义(P<0.01),而外侧中心边缘角、臼顶倾斜角、髋臼覆盖率及Harris评分差异无统计学意义(P>0.05)。结论三维CT能更直接显示和精确测量不同类型的髋臼发育不良改变。Purpose To assess the distribution and measure the degree of acetabular dysplasia without advanced degenerative osteoarthritic changes using three-dimensional CT （3DCT）. Materials and Methods 46 dysplastic hips of 30 patients were studied. X-ray radiography and 3DCT scan were performed before periacetabular osteotomy. The CE angle of Wiberg, AC angle, ACE angle and AcetAV angle, AASA and PASA were measured on X-ray and 3DCT, respectively. Clinical evaluation was performed according to the Harris hip-scoring system. Results There was no statistical difference in CE angle of Wiberg, AC angle and ACE angle between 3DCT and X-ray （P 0.05）. 7 hips were categorized as lateral deficiency, 12 hips as lateral and anterior deficiency, 9 hips as lateral and posterior deficiency, and 18 hips as complete deficiency. Significant differences were found in ACE angle, AcetAV angle, AASA and PASA of the above four groups （P 0.01）. No significant difference was found in CE angle, AC angle, the percentage of acetabular coverage and Harris scores （P 0.05）. Conclusion Deficiency types and degrees of adult acetabular dysplasia can be directly displayed and precisely evaluated by 3DCT.

关 键 词：骨发育不全 髋臼 截骨术 体层摄影术 X线计算机 成像 三维 

分 类 号：R681.1[医药卫生—骨科学] R445.3[医药卫生—外科学]