动态测量非生理状态下髋臼前倾角及其临床意义  

Clinical significance of dynamic measurement of acetabular anteversion angle under non-physiological condition

作　　者：李颖[1] 耿左军[2] 赵秀娟[1] 

机构地区：[1]河北省廊坊市人民医院,065000 [2]河北医科大学第二医院

出　　处：《河北医药》2016年第10期1450-1452,1456,共4页Hebei Medical Journal

基　　金：廊坊市科学技术研究与发展计划(编号:2014013006)

摘　　要：目的通过MSCT三维重建骨盆,计算骨盆在不同倾斜程度下髋臼前倾角数值,指导非生理状态下全髋关节置换术(THA)个体化置入髋臼假体的放置角度。方法本研究选择100例患者(即200个髋臼)为研究对象进行螺旋CT扫描,利用容积再现(VRT)技术把骨盆重建为立体图像,为模拟病理状态进而对骨盆进行不同程度的前倾(以10°为间隔,从10°前倾到90°),利用多平面重组(multi-planar reconstructions,MPR)重建出水平位图像,进而算出前倾角,采用统计学软件计算平均值和标准差,绘制出非生理状态下髋臼前倾角随骨盆倾度改变而发生变化的相关性变化曲线,从中找到规律。结果当骨盆倾度从10°逐渐增加至90°时,前倾角随之减小,变化曲线呈线性相关,拟合后得到的回归方程为y=-0.4613x+40.922,R2=0.9971,线性良好。在相同条件下,不同性别间的前倾角差异无统计学意义(P>0.05)。结论髋臼的前倾角随着骨盆倾度的变化而发生改变,髋臼的前倾角与骨盆倾度呈线性相关,性别因素对髋臼前倾角的影响不大。髋臼前倾角随骨盆倾度动态变化的规律,可以为临床THA手术中髋臼假体放置角度提供理论依据。Objective To calculate numerical value of acetabular anteversion angle in different slope degrees of pelvis by means of three- dimensional reconstruction pelvis through multi-slice spiral CT（ MSCT） in order to guide to place the acetabular prosthesis at right angles during total hip arthroplasty（ THA）. Methods One hundred patients（ 50 males and 50females） including 200 pelvis were scanned by MSCT,and valume rendering technique（ VRT） was used to reconstruct pelvis into stereoscopic picture,to make different degrees of pelvic anteversion angles（ 10° ~ 90°,at an interval of 10°）,and multiplanar reconstructions（ MPR） was used to rebuild horizontal position images,then to calculate anteversion angle,moreover,statistics software was used to calculate mean value and standard deviation to draw related changing curve because of the changing of acetabular anteversion angle under non-physiological condition with the changing of inclination of pelvis so as to find out the rules. Results When inclination of pelvis was increased gradually from 10° to 90°,the anteversion angle was decreased correspondingly,moreover,the changing curve was linearly correlated,the regression equation after fitting was y =- 0. 4613 x ＋ 40. 922,R2 = 0. 9971,with good linearity. The results showed that there was no significant differences in anteversion angle between males and females in the same condition（ P〈0. 05）. Conclusion The acetabular anteversion angle is changed with the changing of pelvic inclination,which shows there is a close linear correlation between acetabular anteversion angle and pelvic inclination,however,there is no significant difference in acetabular anteversion angle between males and females. The dynamic changing rule of acetabular anteversion angle with the changing of pelvic inclination can provide theoretic basis for THA.

关 键 词：体层摄影术 螺旋计算机 髋臼 前倾角 

分 类 号：R445[医药卫生—影像医学与核医学]