髋臼发育不良患者髋臼周围截骨术前的三维CT测量

摘要

目的 使用三维CT测量无晚期骨关节炎的髋臼发育不良患者的髋臼,并分析覆盖缺损类型和程度.资料与方法 30例患者共46个髋关节于髋臼周围截骨术前行X线片和三维CT扫描,分别测量外侧中心边缘角、臼顶倾斜角和前方中心边缘角,及三维CT上的髋臼前倾角、髋臼前角、髋臼后角.应用Harris评分对患者进行临床评估.结果 三维CT和X线片测得的外侧中心边缘角、臼顶倾斜角和前方中心边缘角差异无统计学意义(P＞0.05).根据髋臼覆盖缺损部位分为外侧缺损(7个髋)、外侧+前方缺损(12个髋)、外侧+后方缺损(9个髋)和完全缺损(18个髋)04组前方中心边缘角、髋臼前倾角、髋臼前角和髋臼后角差异有统计学意义(P＜0.01),而外侧中心边缘角、臼顶倾斜角、髋臼覆盖率及Harris评分差异无统计学意义(P＞0.05).结论 三维CT能更直接显示和精确测量不同类型的髋臼发育不良改变.%Purpose To assess the distribution and measure the degree of acetabular dysplasia without advanced degenerative osteoarthritic changes using three-dimensional CT (3DCT). Materials and Methods 46 dysplastic hips of 30 patients were studied. X-ray radiography and 3DCT scan were performed before periacetabular osteotomy. The CE angle of Wiberg, AC angle, ACE angle and AcetAV angle, AASA and PASA were measured on X-ray and 3DCT, respectively. Clinical evaluation was performed according to the Harris hip-scoring system. Results There was no statistical difference in CE angle of Wiberg, AC angle and ACE angle between 3DCT and X-ray (P > 0.05). 7 hips were categorized as lateral deficiency, 12 hips as lateral and anterior deficiency, 9 hips as lateral and posterior deficiency, and 18 hips as complete deficiency. Significant differences were found in ACE angle, AcetAV angle, AASA and PASA of the above four groups (P<0.01). No significant difference was found in CE angle, AC angle, the percentage of acetabular coverage and Harris scores (P> 0.05). Conclusion Deficiency types and degrees of adult acetabular dysplasia can be directly displayed and precisely evaluated by 3DCT.