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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (8): 144-.

• 论文 • 上一篇    下一篇

发育性髋关节脱位髋臼形态的MRI研究

陈帅1,王克来1,庄岩1,曲宏懿2   

  1. 山东大学 1.齐鲁医院小儿外科,  济南 250012; 2.附属千佛山医院小儿外科, 济南 250014
  • 收稿日期:2010-12-23 出版日期:2011-08-10 发布日期:2011-08-10
  • 通讯作者: 王克来(1962- ),男,教授,硕士生导师,主要从事小儿外科矫形专业研究。 E-mail:wkllcl@sohu.com
  • 作者简介:陈帅(1986- ),男,硕士研究生,主要从事小儿外科矫形专业研究。

Acetabular morphology in children with developmental dysplasia of the hip by MRI 

CHEN Shuai1, WANG Kelai1, ZHUANG Yan1, QU Hongyi2   

  1. 1. Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan 250012, China;
    2. Department of Pediatric Surgery, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, China
  • Received:2010-12-23 Online:2011-08-10 Published:2011-08-10

摘要:

目的     通过对发育性髋关节脱位患儿患侧髋臼与正常侧髋臼磁共振成像(MRI)表现的观察,探究发育性髋关节脱位患儿髋臼的病理改变。方法     对12例发育性髋关节脱位的患儿进行髋关节MRI检查,其中单侧脱位8例,双侧脱位4例,共8个正常髋关节(对照组)、16个脱位髋关节(病变组)。测量双侧髋关节骨性髋臼指数(BAI)、软骨性髋臼指数(CAI),骨性髋臼前倾角(BAAV)及软骨性前倾角(CAAV),对所得结果进行统计学分析。结果    BAI与CAI之间存在相关性,对照组两指数间相关系数(0.945)高于病变组的相关系数(0.814)。病变组BAAV与CAAV均明显大于对照组(P<0.01),病变组髋关节的CAAV明显大于BAAV(P<0.01)。所有髋关节BAI与BAAV,CAI与CAAV之间均存在相关性(相关系数分别为0.884和0.822)。结论      发育性髋关节脱位的髋臼病理改变不仅体现在髋臼指数的改变,还体现在髋臼朝向的改变,这两种改变的程度存在着相关性。发育性髋关节脱位髋臼形态的畸形不仅体现在骨性结构,还体现在软骨结构上。两种结构的病理变化并不是完全同步的。采用MRI成像对DDH患儿的软骨结构进行评估可用于指导DDH的术式选择和手术操作。

关键词: 发育性髋关节脱位;磁共振;髋臼前倾;骨性髋臼指数;软骨性髋臼指数

Abstract:

Objective    To investigate pathological changes of the acetabulum by observing magnetic resonance imaging(MRI) of normal and dislocated hips in children with developmental dysplasia of the hip (DDH).  Methods      12 children with DDH(8 unilateral and 4 bilateral dislocated ones) had MRI of acetabulum, and 8 normal and 16 abnormal hips were observed. Acetabular indexes of bone (BAI) and cartilage (CAI) were measured on the coronal sections, and acetabular anteversion indexes of bone (BAAV) and cartilage (CAAV)were measured on the cross sections. The data were statistically analyzed. Results      There was a correlation between BAI and CAI, and the correlation coefficient of normal hips (0.945) was larger than that of abnormal hips (0.814). Differences in BAAV and CAAV between dislocated and normal groups were significant(P<0.01), and CAAV of abnormal hips was larger than their BAAV(P<0.01). There were correlations between BAI and BAAV, as well as between CAI and CAAV, and corresponding correlation coefficients were 0.884 and 0.822, respectively. Conclusion      Pathological changes of the acetabulum in children with DDH are reflected not only in the acetabular index but also in the direction of acetabulum, and there is a correlation between these two changes. Deformity of the acetabulum is reflected in two aspectsbone and cartilage, which have different degrees of deformity. MRI can be used to evaluate deformity of the cartilage before operation, which is helpful for choosing operative methods and guiding surgery process.

Key words: Developmental dysplasia of the hip; Magnetic resonance imaging; Acetabular anteversion; Acetabular index of bone; Acetabular index of cartilage

中图分类号: 

  • R726.8
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