CT三维重建应用于成人发育性髋关节发育不良股骨近端形态学研究的进展及意义  

Research progress and significance of three-dimensional CT reconstruction in the proximal femur morphology of developmental hip dysplasia in adults

作　　者：沈先月 刘潼[1] 杨育晖 肖建林[1] 陈尚钧 左建林[1] 高忠礼[1] Shen Xianyue;Liu Tong;Yang Yuhui;Xiao Jianlin;Chen Shangjun;Zuo Jianlin;Gao Zhongli(Department of Orthopedics,China-Japan Union Hospital of Jilin University,Changchun 130033,China;Department of Orthopedics,Guangdong General Hospital（Guangdong Academy of Medical Sciences）,Guangzhou 510080,China;Norman Bethune College of Medicine,Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学中日联谊医院骨科,长春130033 [2]广东省人民医院(广东省医学科学院)骨科中心关节骨病与创伤科,广州510080 [3]吉林大学白求恩医学部,长春130021

出　　处：《中华老年骨科与康复电子杂志》2018年第6期369-373,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金青年基金(81601907);吉林省科技厅优秀青年基金(20170520019JH)

摘　　要：目的对CT三维重建技术应用于成人发育性髋关节发育不良(DDH)股骨近端形态研究的相对优势,以及DDH CroweⅠ～Ⅳ型股骨近端的测量参数与形态特点进行综述。方法在近年DDH股骨形态研究中以"股骨近端形态""成人DDH""全髋关节置换"及"CT三维重建"为关键词,在PubMed和中国知网数据库中检索近年发表的相关文献,对CT三维重建的DDH股骨近端的应用优势、CroweⅠ～Ⅳ型DDH股骨近端的测量参数与形态特点进行分析总结。结果 DDH是髋关节发生骨性关节炎的重要原因之一。全髋关节置换术(THA)是目前治疗DDH的最有效治疗方法。DDH的髋关节常伴有股骨侧严重的病理改变,尤以CroweⅣ型DDH股骨畸形程度最为严重。术前应用CT三维重建技术可以帮助医生充分认识这些解剖变异,从而可以优化术前设计,缩短手术时间,继而获得良好的手术效果,降低术后并发症。结论采用CT三维重建技术能全面显示髋关节的立体形态和各部位解剖结构的空间关系,在DDH的诊断、分型,股骨近端形态个体化建立、股骨侧假体的选择,THA中股骨假体植入准确度的提高及术后并发症的降低都发挥着重要的作用。Objective To summarize the advantages, measurement parameters and the proximal femur morphology of CroweⅠ～Ⅳdevelopmental dysplasia of the hip （DDH） in adults in the CT three-dimensional reconstruction （CT 3DR）. Methods To search and consult all the literatures available by the key words of the proximal femur morphology, DDH in adults,THAand CT 3DR in the database of Pub Med and CNKI to analyze and summarize the advantages of CT 3DR, measurement parameters and the proximal femur morphology of Crowe Ⅰ～ⅣDDHin adults by referring to recent relevant database. Results DDHin adults is one of the important causes of osteoarthritis in the hip joint. THAis currently the most effective treatment for DDH. The hip joint of DDH is often accompanied by severe pathological changes in the proximal femur morphology, especially Crowe type Ⅳ preoperative CT 3DR can recognize the anatomical variations, which can optimize preoperative design, shorten the operation time, and obtain good surgical results and reduce postoperative complications.Conclusions CT 3DR displays the morphology and anatomical structure of spatial relations of the hip joint comprehensively and accurately. It plays an important role in the diagnosis and classification of DDH in adults,the individualized formation of the proximal femur, the selection of the femoral prosthesis, and in the improvement of the accuracy of the implantation of the femoral prosthesis and reduction of postoperative complications.

关 键 词：髋脱位 先天性 成像 三维 关节成形术 置换 髋 股骨近端 

分 类 号：R684[医药卫生—骨科学] R816.8[医药卫生—外科学]