三维CT对小儿髋关节发育不良中髋臼形态的分析

目的　评估三维CT对小儿髋关节发育不全 (DDH)中髋臼形态观察的应用价值。方法　随机抽取临床及骨盆平片诊断为DDH的患儿 3 0名 (共 49个患髋 )治疗前行CT扫描 ,患者年龄从 14个月～ 12岁 ,平均 4.2 5岁 ,其中男 4人 ,女 2 6人。男女比 1:6.5。 3 0例DDH中双侧性 19例 ,11例单侧性中 ,左侧 7例 ,右侧 4例 ,左右比 1.5 :1。表面重建后进行髋臼的形态分析。结果　DDH病变组的髋臼大致可分为以下 5型 :Ⅰ型 7例 ,髋臼顶呈犬牙状不规则 ,髋臼顶髂骨前后缘连线变平或略向前下倾斜 ;Ⅱ型 14例 ,髋臼顶前上缘发育不良 ,髂骨前后缘连线向后下倾斜 ;Ⅲ型 17例 ,髋臼顶中上部或中后部局限性凹陷 ;Ⅳ型 ,7例 ,弥漫性髋臼顶发育不良 ;Ⅴ型 4例 ,髋臼凹稍变浅 ,而髋臼顶发育基本正常。结论　CT能直观地显示髋臼的形态及其发育情况 ,对临床制定进一步治疗方案、指导手术有着重要作用

3D CT Analysis of Acetabulum Morphology in Developmental Dysplasia of Hip

Objective To evaluate the applied value of 3DCT in detecting the acetabulum morphology in patients with developmental dysplasia of hip(DDH).Methods 30 cases of DDH diagnosed by clinics and plain films were scaned by spiral CT,ranged in age from 14 month to 12 years old.Bilateral DDH was found in 19 cases.Within the 11 cases of unilateral DDH,7 were left-sided.Surface-shade reconstruction was made to observe the morphology of acetabula.Results The morphology of acetabula could be divided into five types: type I: 7 cases, irregular of the roof of acetabulum; type II: 14 cases, anterior-superior deficiency; type III: 17 cases, mid-superior deficiency; type IV: 7 cases, global deficiency and type V: 4 cases, smooth roof with slightly shallowed acetabular roof.Conclusion 3DCT can reveal the shape and development of acetabula. It can help to determine the further treatment of the patients.