髋关节发育不良继发骨关节炎的影像学比较研究134例  

134 Cases Comparative Study on Dysplasia of the Hip Secondary Imaging in Osteoarthritis

作　　者：刘胜[1] 

机构地区：[1]菏泽医学专科学校,山东菏泽274000

出　　处：《菏泽医学专科学校学报》2015年第4期8-10,62,共4页Journal of Heze Medical College

摘　　要：目的探讨髋关节发育不良继发骨关节炎不同影像学的诊断价值。方法选择髋关节发育不良患者的影像学资料134例,对其患者的年龄、CE角、sharp角、股骨头覆盖率、关节内间隙、关节上间隙、髋顶切线角、髋臼指数等进行分析。按照合并骨关节炎分为两组,比较CE角、sharp角、股骨头覆盖率、关节内间隙、关节上间隙、髋顶切线角、髋臼指数等测量值。采用SPSSl5.0统计学软件,所获数据两组间比较采用F检验。结果 crowe I期91例,Ⅱ期24例,Ⅲ期12例,Ⅳ期7例。CE角〈20°者91例,sharp角〉45°者43例,髋臼指数〈41.6%者62例,股骨头覆盖率〈70%者111例,髋顶切线角≤0°者123例。shenton线不连续107例,Calve线不连续123例。髋关节内侧间隙增宽103例,髋关节上间隙变窄36例。出现并发症者123例,其中髋关节半脱位和脱位者99例,囊状改变48例。X线片、CT、MRI对134例髋臼发育不良患者并发囊变的检出率分别为35.82%、59.70%和100%。继发髋关节骨关节炎36例;双侧8例,单侧28例。两组CE角、股骨头覆盖率、关节内间隙、关节上间隙、髋顶切线角比较P〈0.05～0.01,有显著性差异;两组sharp角、髋臼指数比较P〉0.05,无显著性差异。X线、CT、MRI比较各有特点,MRI诊断准确率最高。结论髋关节发育不良继发骨关节炎女性多见,多为单侧,与年龄密切相关,早发现、早治疗,预防从新生儿做起,加强髋关节负荷训练,降低髋关节发育不良发生率。Objective To investigate the dysplasia of the hip secondary osteoarthritis different imaging diagnostic value. Methods Select 134 cases of patients hip hair with bad the imaging data to analyse, CE Angle, sharp Angle, coverage, femoral head joint clearance, joint clearance, hip roof on tangent Angle and acetabulum index.Divided into two groups according to the combination of osteoarthritis and compare the CE Angle and sharp Angle, coverage, femoral head joint clearance, joint clearance, hip roof on tangent Angle, acetabulum index measured values. Using SPSSl5. 0 statistical software to compare the two groups date by f test. Results 91 cases, crowe stage IⅡ period 24 cases, 12 cases Ⅲ period, Ⅳ period 7 cases. CE Angle of 20°. In 91, sharp Angle 〉45°. 43 cases, acetabulum index 41.6% of the 62 cases,femoral head coverage 70% of the 111 cases, hip roof tangent Angle 0 or less o 123 cases. 107 cases of shenton line discontinuous Calve line discontinuous in 123 cases. 103 cases of hip inside clearance and narrow clearance 36 cases on the hip. Complications of 123 cases, including 99 cases of subluxation and dislocation of the hip, 48 cases of cystic change. Xray films, CT and MRI of 134 patients with acetabulum hypoplasia concurrent cystic change detection rate of 35.82%,59.70% and 100% respectively. Secondary osteoarthritis of the hip 36 cases; Bilateral 8 cases, 28 cases uni lateral. Two groups of CE Angle, coverage, femoral head joint clearance, joint clearance, hip roof on tangent Angle is P 0.05 ～ 0.01, there is significant difference; Two groups of sharp Angle, index of the acetabulum is P 0.05, no significant differences. X-ray, CT and MRI are each have characteristics of MRI in the diagnosis of the highest accuracy. Conclusion The dysplasia of the hip secondary osteoarthritis is always finding in woman, it is closely related to age, and should detect and treat early and prevent from newborn baby, reinforcing the training of the hip joint load, reduce the incidence of hip dysplasia.

关 键 词：髋臼 髋脱位骨关节炎 髋臼发育不良 X线 X线体层摄影术 螺旋计算机磁共振成像 

分 类 号：R445.4[医药卫生—影像医学与核医学] R681.1[医药卫生—诊断学]