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目的:通过3D-CT影像学分析,探讨小儿发育性髋脱位(DDH)髋臼的病理学改变。方法:收集44例6个月～14岁的DDH患儿的髋关节二维CT影像,进行三维重建,观察病变后髋臼的变化情况。结果:髋臼上缘缺陷在全脱位组主要为Ⅲ型、Ⅳ型,Ⅳ型达100%;半脱位组Ⅳ型比例降至92%;发育不良组主要是Ⅰ、Ⅱ型,没有Ⅳ型。全脱位组坐骨凸起率为100%,髂骨凸起率约82%,发育不良组无髂骨凸起现象。髋臼窝中、重度畸形主要分布在全脱位组和半脱位组。髋臼中心厚度除婴幼儿组外均增加,与正常组相比有统计学差异(P<0.05)。髋臼指数、髋臼横径和髋臼前倾角与同龄组的正常值相比无统计学差异(P>0.05)。结论:随着髋脱位程度增加,髋臼上缘缺陷严重,坐骨厚度增加明显,坐骨和髂骨凸起导致髋臼窝中、重度畸形。
OBJECTIVE: To investigate the pathological changes of acetabulum in pediatric developmental hip dislocation (DDH) by 3D-CT imaging analysis. Methods: Two-dimensional CT images of 44 children with DDH from 6 months to 14 years old were collected and reconstructed by three-dimensional reconstruction. The changes of acetabulum after the lesion were observed. Results: The upper edge of the acetabulum in the total dislocation group was mainly type Ⅲ, type Ⅳ, type Ⅳ up to 100%; type Ⅳ subluxation decreased to 92%; dysplasia group is mainly Ⅰ, Ⅱ, no type Ⅳ. Total dislocation group was 100%, the incidence of iliac protrusion was about 82%, dysplasia without iliac protrusion. In the acetabular fossa, the severe deformities were mainly distributed in the total dislocation group and the subluxation group. Acetabular center thickness except for infants and young children were increased, compared with the normal group was statistically significant (P <0.05). Acetabular index, acetabular diameter and acetabular anteversion angle compared with the normal group had no significant difference (P> 0.05). Conclusion: With the increase of hip dislocation, the defect of the upper edge of the acetabulum is serious, the thickness of the ischial bone increases obviously, and the ischial and iliac protuberances lead to the medium and severe deformity of the acetabulum.