MRI对儿童发育性髋关节脱位的髋臼发育状况分析

目的 探讨MRI对儿童不同年龄阶段发育性髋关节脱位(developmental dislocation of the hip,DDH)髋臼发育情况的分析及应用价值.方法 对我院2010年1月至2015年1月诊治的单侧DDH患儿共76例进行回顾性分析,患侧为病例组,健侧为对照组;根据年龄分为三组:婴儿组(＜1岁)14例、幼儿组(1～3岁)38例及儿童组(4～13岁)24例.比较各组间髋臼深度、骨性髋臼指数(BAI)、软骨性髋臼指数(CAI)的差异,并进行线性相关分析;同时分别测量病例组与对照组的髋臼软骨在前上、顶上、后上三个方向的分布情况.结果 病例组与对照组髋臼深度为(5.54±2.32) mm和(9.32±2.91) mm、BAI为(33.65±5.08)°和(23.12±5.28)°,CAI为(20.86±6.38)°和(12.81±4.71)°,两组差异有统计学意义(t=12.86、14.82、9.56,P均＜0.05),BAI、CAI呈线性正相关(r=0.88、0.74,P＜0.05);病例组中婴儿组、幼儿组及儿童组髋臼深度分别为(4.31±0.42)mm、(4.69±1.74)mm及(7.31±2.74)mm,差异有统计学意义(F=11.88,P＜0.05),BAI分别为(29.16±5.03)°、(34.95±4.50)°及(33.12±5.69)°,CAI分别为(16.80±5.21)°、(21.53±6.49)°及(20.91±6.40).,BAI、CAI在幼儿组及儿童组呈线性正相关(r=0.70、0.66,P＜0.05).幼儿组及儿童组中病例组与对照组的髋臼软骨分布在前上、顶上、后上差异均有统计学意义(P＜0.05).结论 MRI可运用于不同年龄阶段儿童DDH的髋臼深度、BAI、CAI、多方向髋臼软骨的测量,为临床评估髋臼发育情况提供更多的影像学参考依据.

Magnetic resonance imaging study of acetabulum in developmental dislocation of the hip for children

Objective To explore the diagnostic value and severity assessment of magnetic resonance imaging (MRI) in acetabulum of developmental dislocation of the hip (DDH) for children at different ages.Methods Between January 2010 and January 2015,a total of 76 unilateral DDH cases of hip MRI data were retrospectively analyzed.Affected hips were included into patient group while normal hips served as control group.Infant group was aged under 1 year (n =14),young children group 1-3 years (n =38) and children group 4-13 years (n =24).Bony and cartilaginous hip parameters of all hips,including depth of acetabulum,bony acetabular index (BAI) and cartilaginous acetabular index (CAI),were measured in T1W1 sequence on coronal MRI.And the distribution of acetabular cartilage was measured simultaneously in all groups.Results Depth of acetabulum was (5.54 ± 2.32)mm and (9.32 ± 2.91) mm,BAI was (33.65 ± 5.08) and (23.12 ± 5.28) and CAI was (20.86 ± 6.38)and (12.81 ± 4.71) in patient and control groups respectively.Differences in depth of acetabulum,BAI and CAI existed between patient and control groups.And three indices except for CAI for three age groups were statistically significant (P＜0.05).A liner correlation existed between BAI and CAI in patient and control groups and separate three age groups (r =0.74,0.88,0.70,0.66,P＜0.05).The distribution of acetabular cartilage in anterosuperior,top and posterosuperior side was abnormal and difference was statistically significant in children aged over 1 year (P＜0.05).Conclusions MRI is an effective imaging modality for assessing bony and cartilaginous structures.And it provides important rationales for assessing the developmental status of acetabulum in DDH.