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[目的]研究晚期髋关节结核髋臼骨破坏三维特点。[方法]2010年11月~2016年12月确诊的晚期髋关节结核病患者73例,男性39例,女性34例,平均年龄(47.95±16.61)(19~85)岁。所有患者采用320排CT行骨盆容积扫描,将DICOM格式数据应用Mimics软件行骨盆三维重建。应用镜像技术还原变病髋臼破坏前三维结构,将正常髋臼设定为标准半球,应用球面拟合技术确定髋臼中心,根据标记点将病变髋臼分为上区、前区、下区和后区。计算出正常髋臼容积、髋臼骨破坏总容积及各分区骨破坏容积。将髋臼骨破坏容积值及各区破坏容积值换算成占正常髋臼容积百分比。根据骨破坏容积占髋臼容积百分比将髋臼骨破坏程度划分为3度,轻度:<50%;中度:50%~100%;重度:>100%。根据单一区骨破坏占总破坏容积百分比将髋臼骨破坏分为2型,弥漫型:<50%;节段型:≥50%。[结果]73例患者髋臼破坏容积占髋臼容积比例平均为(0.62±0.48)(0.06~1.68);髋臼破坏程度:轻度破坏36例(50%),中度破坏25例(36%),重度破坏12例(14%);髋臼骨破坏分型:弥漫型骨破坏56例(77%),节段型骨破坏17例(23%);上区骨破坏容积大于前区、后区骨破坏容积(P<0.05),前区、后区骨破坏容积大于下区骨破坏容积(P<0.05),前区骨破坏容积与后区比较差异无统计学意义(P>0.05)。[结论]采用320排CT行骨盆容积扫描,数据用Mimics软件三维重建,髋臼骨破坏进行分区容积计算,确定晚期髋关节结核髋臼骨破坏形态、方位、程度及类型,可全面反映晚期髋关节结核髋臼骨破坏的三维特点,有助于治疗计划的制定。
[Objective] To study the three-dimensional characteristics of acetabular bone destruction in advanced hip tuberculosis. [Method] 73 patients with advanced hip tuberculosis confirmed from November 2010 to December 2016 were 39 males and 34 females, with an average age of 47.95 ± 16.61 years (19-85 years). All patients with 320 row CT pelvis volume scanning, the DICOM format data using Mimics software pelvic three-dimensional reconstruction. Using mirror technology to restore the three-dimensional structure of the diseased acetabulum, the normal acetabulum was set as the standard hemisphere, and the center of the acetabulum was determined by the spherical fitting technique. The diseased acetabulum was divided into the upper area, the anterior area and the lower area And back area. The normal acetabular volume, the total volume of acetabular bone destruction and the volume of bone destruction in each area were calculated. The value of the acetabular bone destruction volume and the volume of destruction of each area is converted into a normal acetabular volume percentage. The degree of acetabular fractures was divided into 3 degrees according to the percentage of acetabular volume due to the volume of bone destruction, mild: <50%; moderate: 50% ~ 100%; severe:> 100%. According to a single area of bone destruction accounted for the total destruction volume percentage of acetabular bone destruction is divided into 2 types, diffuse type: <50%; segmental type: ≥ 50%. [Results] The average acetabular volume in the 73 patients was (0.62 ± 0.48) (0.06-1.68). The degree of acetabular destruction was mild in 36 (50%) and moderate in 25 %), Severe destruction of 12 cases (14%); acetabular bone destruction type: 56 cases of diffuse bone destruction (77%), 17 cases of segmental bone destruction (23% (P <0.05). The volume of bone destruction in the anterior and posterior regions was greater than that in the inferior region (P <0.05), while there was no significant difference between the anterior and posterior regions ). [Conclusion] With 320-slice CT pelvic volume scan, the data were calculated by 3D reconstruction with Mimics software and the dislocation of acetabular bone to determine the shape, orientation, degree and type of acetabular bone destruction in late stage of hip tuberculosis, which can fully reflect the late hip The three-dimensional characteristics of joint tuberculosis acetabular bone destruction contribute to the development of treatment plans.