【摘要】 目的:通过3D-CT影像学分析,探讨小儿发育性髋脱位(DDH)髋臼的病理学改变。方法:收集44例6个月～14岁的DDH患儿的髋关节二维CT影像,进行三维重建,观察病变后髋臼的变化情况。结果:髋臼上缘缺陷在全脱位组主要为Ⅲ型、Ⅳ型,Ⅳ型达100%;半脱位组Ⅳ型比例降至92%;发育不良组主要是Ⅰ、Ⅱ型,没有Ⅳ型。全脱位组坐骨凸起率为100%,髂骨凸起率约82%,发育不良组无髂骨凸起现象。髋臼窝中、重度畸形主要分布在全脱位组和半脱位组。髋臼中心厚度除婴幼儿组外均增加,与正常组相比有统计学差异(P<0.05)。髋臼指数、髋臼横径和髋臼前倾角与同龄组的正常值相比无统计学差异(P>0.05)。结论:随着髋脱位程度增加,髋臼上缘缺陷严重,坐骨厚度增加明显,坐骨和髂骨凸起导致髋臼窝中、重度畸形。更多还原

【Abstract】 Objective:To explore the pathological changes of infantile development dislocation of hip(DDH) by 3D-CT image analysis. Methods:Two-dimensional CT images of forty-four infants with DDH aged 6 months-14 years were collected,three-dimensional reconstruction was conducted,the change of acetabulum was observed. Results:The main types of superior border defect of acetabulum in complete dislocation group were type Ⅲ and type Ⅳ,the proportion of type IV was 100%;the proportion of type Ⅳ in subluxation group decreased to 92%;the main types of superior border defect of acetabulum in dysplasia group were type Ⅰ and type Ⅱ,no type Ⅳ was found.In complete dislocation group,the bump rate of ischium was 100%,the bump rate of ilium was 82%;in dysplasia group,there was no bump of ilium.In acetabular fossa,severe malformation mainly distributed in complete dislocation group and subluxation group.Except infant group,the thicknesses of acetabular center in the other groups increased,compared with normal group,there was significant difference(P<0.05).There was no significant difference in acetabular index,acetabular transverse diameter,and acetabular femoral neck anteversion between the infants and normal values of the same age group(P>0.05). Conclusion:Superior border defect of acetabulum become severe with the increase of degree of DDH,the thickness of ischium increases obviously,bump of ischium and ilium can induce moderate and severe malformation of acetabular fossa.更多还原