儿童髋臼前倾的发育规律研究

目的通过MRI测量正常儿童的髋臼骨性前倾角(osseous acetabular anteversion,OAA)及软骨性前倾角(cartilaginous acetabular anteversion,CAA),明确从出生至骨成熟儿童OAA及CAA的发育规律。方法回顾性收集2008年1月至2018年1月中国医科大学附属盛京医院收治的293例髋关节发育正常儿童的髋关节MRI影像学资料,其中男童147例,女童146例;年龄1个月至16岁,平均年龄8.01岁。在通过髋臼中心的轴面图像上测量OAA和CAA,比较正常儿童OAA和CAA随年龄变化的趋势。结果正常儿童OAA在生后1岁时为(8.69±3.16)°,2岁时增大至(11.83±2.95)°;2~9岁之间维持恒定。9~16岁,OAA略有上升,16岁时达到(14.37±3.55)°。正常儿童CAA在生后1岁时为(12.29±3.13)°,2岁时增大至(15.19±2.68)°,之后不随年龄变化,维持在(15.17±3.38)°,直至16岁达到成人水平。结论 CAA在生后2年内迅速发育至成人水平,后不随年龄而变化;骨性髋臼前倾则随年龄而逐渐增大。在儿童时期,不能用OAA代替CAA,在儿童髋关节手术前,应通过MRI评价CAA的前倾程度。

Developmental regularity of acetabular anteversion in normal children

Objective To observe the developmental and growth patterns of osseous acetabular anteversion(OAA) and cartilaginous acetabular anteversion(CAA) with different ages on magnetic resonance imaging(MRI).Methods We retrospectively analyzed the medical records of children receiving hip MRI examination from January 2008 to January 2018.Among 293 children with normal development of the hips,there were 147 boys and 146 girls with a mean age of 8.01 years(1 month to 16 years).The values of OAA/CAA were measured on cross-sections on MRI and their normal developmental patterns determined by age-based cross-sectional analysis.The differences of OAA/CAA were compared between normal and DDH children.The data were statistically analyzed.Results Normal OAA increased from a mean value of 8.69°±3.16°to 11.830°±2.95°during the first two postnatal years.Then it stayed unchanged until 9 years.From 9 to 16 years,OAA showed a slight increase of 2°-3°again.The mean value of OAA rose to 14.37°±3.55°at the age of 16 years.Normal CAA spiked rapidly from a mean value of 12.29°±3.13°to 15.19°±2.68°within the first two years and then stabilized at a constant level of 15.17°±3.38°until 16 years.Conclusion Normal CAA has fully formed at birth and remains constant until adulthood.In childhood,osseous-anteversion does not represent cartilaginousanteversion.And MRI is necessary for assessing acetabular cartilage components prior to hip surgery.