CT三维重组诊断成人重度髋关节发育不良继发性骨关节炎的价值  

Value of CT Three-Dimensional Reconstruction in Diagnosing Severe DDH Secondary to Osteoarthritis in Adults

作　　者：李向阳 王浩东[1] 陈鑫怡 唐光燕 兰九钧 LI Xiangyang;WANG Haodong;CHEN Xinyi(Sichuan Orthopaedic Hospital,Sichuan Chengdu 610041,China)

机构地区：[1]四川省骨科医院放射科,四川成都610041

出　　处：《河北医学》2023年第7期1188-1192,共5页Hebei Medicine

基　　金：四川省中医药管理局基金,(编号:2021MS330)。

摘　　要：目的:探讨CT三维重组诊断成人重度髋关节发育不良(DDH)继发性骨关节炎(OA)的价值。方法:选取2018年1月至2021年1月在本院住院的106例重度成人DDH患者为研究对象,根据是否发生OA,分为OA组(29例)和非OA组(77例)。比较两组患者髋臼指数、髋关节上间隙、髋关节内侧间隙、Sharp角、CE角、髋顶切线角、股骨头覆盖率,并将具有统计学意义的影像学指标纳入诊断指标,分析其单独及联合检测对重度DDH患者合并OA的诊断效能。结果:OA组髋关节上间隙、CE角、髋顶切线角、股骨头覆盖率小于非OA组,髋关节内侧间隙大于非OA组(P<0.05),两组髋臼指数、Sharp角比较,差异无统计学意义(P<0.05)。ROC曲线显示,髋关节上间隙、髋关节内侧间隙、CE角、髋顶切线角、股骨头覆盖率诊断重度DDH合并OA的AUC分别为0.749、0.725、0.779、0.683、0.694,均低于这五者联合诊断的AUC 0.881(P<0.05)。结论:CT三维重组在成人重度DDH患者合并OA的早期诊断中,具有较高的应用价值。Objective:To explore the diagnostic value of CT three-dimensional reconstruction for severe developmental dysplasia of the hip(DDH)secondary to osteoarthritis(OA)in adults.Methods:A total of 106 adult patients with severe DDH admitted to the hospital were enrolled as the research objects between January 2018 and January 2021.According to presence or absence of OA,they were divided into OA group(29 cases)and non-OA group(77 cases).The acetabular index,upper and medial space of hip joints,Sharp angle,CE angle,tangent angle of hip roof and coverage rate of femoral head were compared between the two groups.The imaging indexes with statistical significance were included into the diagnostic indexes to analyze the diagnostic efficiency of single index and their combination for OA in patients with severe DDH.Results:The upper hip space,CE angle,tangent angle of hip roof and coverage rate of femoral head in OA group were lower than those in non-OA group,while medial hip space was larger than that in non-OA group(P<0.05).There was no significant difference in acetabular index or Sharp angle between the two groups(P<0.05).ROC curves showed that AUC values of upper hip space,medial hip space,CE angle,tangent angle of hip roof and coverage rate of femoral head in the diagnosis of severe DDH combined with OA were 0.749,0.725,0.779,0.683 and 0.694,respectively,lower than that of combined diagnosis(0.881,P<0.05).Conclusion:CT three-dimensional reconstruction has high diagnostic value for severe DDH combined with OA in the adults.

关 键 词：CT三维重组 成人 重度 髋关节发育不良 继发性骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]