高频超声、MRI检查对婴幼儿髋关节脱位的临床应用价值探讨  

Clinical Value of High-frequency Ultrasound and MRI in Diagnosis of Hip Dislocation in Infants

作　　者：张光武 周少萍[1] ZHANG Guang-wu;ZHOU Shao-ping(Department of Ultrasound,Puren Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430081,Hubei Province,China)

机构地区：[1]武汉科技大学附属普仁医院(武汉市普仁医院)超声科

出　　处：《中国CT和MRI杂志》2019年第11期128-131,共4页Chinese Journal of CT and MRI

基　　金：湖北省卫计委联合基金面上项目(编号WJ2018H0093)

摘　　要：目的探讨高频超声、MRI检查对婴幼儿髋关节脱位的临床应用价值。方法选取2017年9月至2018年9月我院收治的怀疑髋关节脱位婴幼儿120例,患者均进行了高频超声、MRI检查,收集患者影像学资料及临床资料,比较两种检查对髋关节脱位的阳性检出率、检查费用,总结高频超声、MRI检查中髋关节脱位的图像表现。结果120例怀疑髋关节脱位的患者中,确诊为髋关节脱位者共10例,高频超声对婴幼儿髋关节脱位阳性检出例数为9例,阳性检出率90.00%,MRI对婴幼儿髋关节脱位阳性检出例数为10例,阳性检出率100.00%,两种检查对髋关节脱位的阳性检出率比较差异无统计学意义(P>0.05)。MRI检查髋关节脱位的费用为(450.00±59.47)元,高于高频超声(126.86±24.15)元,差异有统计学意义(P<0.001);髋关节脱位超声图像可见盂唇为内翻,骨性臼顶的边缘较扁,股骨头呈现完全脱位,将软骨性臼顶推向下方,盂唇增大,被卡压在股骨头与软骨性臼顶间。正常髋关节髋臼内T1WI、T2WI未见高信号影像,出现脱位髋关节侧髋臼内可见不同程度的高信号影像,其中髋臼内超过1/2区域或完全呈现为高信号影者4例,2例患者髋臼内存在少量高信号依附于臼缘。结论高频超声、MRI检查均可有效检出婴幼儿髋关节脱位,高频超声检查费用较低,MRI检查可多方位观察髋关节脱位情况,临床可根据患者个人情况选择检查方式。Objective To investigate the clinical value of high frequency ultrasound and MRI in the diagnosis of hip dislocation in infants.Methods 120 infants suspected of dislocation of hip were selected from September 2017 to September 2018.All patients underwent high frequency ultrasound and MRI examination.The imaging data and clinical data of patients were collected,and the positive detection rate and cost of the two examinations were compared.The image manifestations of hip dislocation in high frequency ultrasound and MRI were summarized.Results Among 120 cases suspected of hip dislocation,10 cases were diagnosed as hip dislocation,9 cases were positive for infantile hip dislocation by high frequency ultrasound,the positive detection rate was 90.00%,10 cases were positive for infantile hip dislocation by MRI,the positive detection rate was 100.00%.There was no significant difference between the two examinations in the positive detection rate of hip dislocation.(P>0.05).The cost of MRI examination for hip dislocation was(450.36±59.47)yuan,which was higher than that of high frequency ultrasound(126.86±24.15)yuan.The difference was statistically significant(P<0.001).Ultrasound images of dislocation of the hip showed that the glenoid labrum was inverted,the edge of the top of the acetabulum was flat,and the caput femoris showed complete dislocation.The cartilaginous acetabulum was pushed downward,the glenoid labrum was enlarged,and was compressed between the top of the femoral head and the cartilaginous acetabulum.There were no high signal images on T1WI and T2WI in normal acetabulum,and high signal images could be seen in different degrees in dislocated acetabulum.Among them,4 cases showed high signal images in more than 1/2 area of acetabulum,and 2 cases had a small amount of high signal in acetabulum attached to the acetabulum margin.Conclusion High-frequency ultrasound and MRI can effectively detect hip dislocation in infants and young children.The cost of high-frequency ultrasound examination is low.MRI examination

关 键 词：高频超声 MRI检查 婴幼儿髋关节脱位 临床应用价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684[医药卫生—诊断学]