三维CT重建在评价发育性髋关节脱位髋臼形态中的应用

目的探讨螺旋三维CT重建（3D—CT）对发育性髋关节脱位（DDH）髋臼形态改变的应用价值。方法选择47例3岁以下DDH惠儿，行三维CT重建检查观察髋臼的病理形态，从髋臼的前、后、外、下多个平面分别测量前外侧臼唇角（ALAL）、侧面髋臼上缘倾斜度（LAI）、髋臼前倾角（AA）和髋臼横向旋转角（TRA）等参数。结果DDH患儿异常侧的ALAL、LAI、AA和TRA均大于正常侧（P〈0．05），各项参数均较正常侧具有显著性差异。正常侧髋臼的髋臼横向旋转角TRA，〈18个月组平均为（12．37．4-4．54）°，≥18个月组平均为（12．91±4．35）°，P=0．324，差异无统计学意义；而脱位侧髋臼的髋臼横向旋转角TRA，〈18个月组平均为（24．50±4．21）°，≥18个月组平均为（23．03±5．11）°，P=0．043，有显著性差异。结论三维CT测量对揭示DDH时髋关节的病理改变具有重要临床应用价值。

The Application of Three -dimensional CT Reconstruction in Evaluating Acetabular Morphology of Developmental Dislocation of the Hip

Objective To explore the application value of three -dimensional spiral CT reconstruction （3D -CT） in acetabular morphology of developmental dislocation of the hip （DDH）. Methods The 3 D - CT reconstruction check - up were carried out to 47 cases of DDH children under 3 years old to observe the pathological morphology of acetabulum. An- terolateral mortar under lip Angle （ ALAL）, side edge gradient on the acetabulum （ LAI）, acetabulum anterior Angle （AA）, acetabulum lateral rotation Angle （TRA） and other parameters were measured from muhiple planes of the acetabu- lum （the front, rear, outer and under planes）. Results Abnormal lateral ALAL, LAI, AA and TRA of the DDH patients were greater than the normal side （P 〈 0. 05 ）, and each parameter had greater significant differences than the normal side. Lateral rotation angle （TRA） of normal bilateral acetabulum in the less than 18 month group was （ 12. 37 ＋ 4. 54） ~on av- erage , while TRA of the more than or equal to 18 month group was （ 12. 91 ＋ 4. 35） ~, P =0. 324, so there was no sig- nificant statistical difference. Dislocation bilateral acetabulum TRA of the less than 18 month group was （24. 50 ＋ 4. 21 ） on average, while TRA of the more than or equal to 18 month group was （23.03 ＋ 5. 11 ） ~, P = 0. 043, so there was significant difference. Conclusion 3D - CT measurement has important clinical value in revealing DDH hip pathologic change.