应用CT三维重建评价发育性髋关节脱位儿童的髋关节形态特征  

Morphological characteristics of hips in children with developmental dislocation of the hip: three-dimensional reconstruction of computed tomography scan

作　　者：郝运[1] 何金鹏[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,湖北省武汉市430030 [2]华中科技大学同济医学院附属同济医院小儿外科,湖北省武汉市430030

出　　处：《中国组织工程研究》2017年第7期1092-1097,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:发育性髋关节脱位患儿的髋关节发育情况一直沿用骨盆X射线平片进行评价,主要观察沈通氏线是否连续及骨骺核的位置,尚缺乏量化和客观的评价方法。目的:应用CT三维重建坐标系构建发育性髋关节脱位患儿的髋关节三维重建数字化模型,精确量化髋关节旋转中心,从而用于准确评价脱位程度。方法:收集2010年12月至2014年12月在华中科技大学附属同济医院行CT检查的单侧发育性髋关节脱位患儿,其中CT影像学资料可获取者有16例,男4例,女12例;平均年龄(4.42±2.59)岁;左侧10例,右侧6例;所有CT资料经过三维重建分析处理构建3D数字化模型,采用逆向工程软件建立三维重建坐标系,并在三维坐标系中采用球体拟合工程逆向求解方法构建髋臼的旋转中心、股骨头的旋转中心以及骨化半径,计算骨化半径比和脱位距离。结果与结论:(1)健侧髋臼旋转中心点与股骨头旋转中心点重合,其X轴、Y轴和Z轴坐标差异无显著性意义(Px>0.05,Py>0.05,Pz>0.05),患侧髋臼旋转中心与股骨头旋转中心不相重合,差异有显著性意义(Px=0.052,Py<0.05,Pz<0.05);(2)健侧髋臼与患侧髋臼的骨化半径差异无显著性意义(P>0.05);健侧股骨头与患侧股骨头的骨化半径分别(21.37±4.42)mm和(20.14±3.14)mm,差异有显著性意义(P<0.05);(3)健侧骨化半径比和患侧骨化半径比分别为0.544±0.069和0.522±0.088,差异无显著性意义(P>0.05);(4)患侧髋关节的脱位距离为8.64-35.28 mm,平均(19.47±7.84)mm;(5)结果表明,应用CT三维重建可以构建发育性髋关节脱位患儿的髋关节3D数字化模型,并可以据此准确构建髋关节的旋转中心点,进而能够准确测量髋关节脱位距离。BACKGROUND： The development of hip joint in children with developmental dislocation of the hip （DDH） has been evaluated by X-ray plain film, which mainly presents Shen Tong＇s line continuity and epiphyseal nucleus position. There is still a lack of quantitative andobjective evaluation methods. OBJECTIVE： To evaluate the rotation center and dislocation degree in DDH children by using three-dimensional （3D） computed tomography （CT）.METHODS： Preoperative 3D CT was performed for 16 unilateral DDH from December 2010 to December 2014 in Tongji Hospital of Huazhong University of Science and Technology, with 4 males and 12 females, at the mean age of （4.42±2.59） years. There were 10 cases on the left side and 6 cases on the right side. 3D digital models were constructed by analysis. The 3D coordinate system was established with reverse engineering software. In 3D coordinate system, using inverse solution method of sphere fitting engineering, the rotation center of the acetabulum, the rotational center of the femoral head, and the radius of ossification were constructed. Ossific radius ratio and dislocation length were calculated.RESULTS AND CONCLUSION： （1） The acetabulum has the same point as the rotation center with the head of femur, and no significant difference in X, Y, and Z coordinates was detected （Px 〉 0.05, Py 〉 0.05, Pz 〉 0.05）. However, it is not the same condition in ipsilateral acatabular rotation center and femoral head rotation center, showing significant differences （Px=0.052, Py 〈 0.05, Pz 〈 0.05）. （2） There were no significant differences in ossific radius between the healthy and affected sides （P 〉 0.05）. The ossific radius was （21.37±4.42） mm and （20.14±3.14） mm on the healthy and affected sides of the femoral head （P 〈0.05）. （3） There was no significant difference in ossific radius ratio between healthy and affected sides （0.544±0.069 and 0.522±0.088; P 〉 0.05）. （4） The dislocation length was 8.64-35.28 mm, mea

关 键 词：骨疾病 发育性 髋关节 图像处理 计算机辅助 成像 三维 组织工程 骨科植入物 数字化骨科 CT三维重建 三维坐标系 数字化3D模型 发育性髋关节脱位 旋转中心点 脱位程度 

分 类 号：R38[医药卫生—医学寄生虫学]