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目的通过MRI定量分析,探讨发育性髋关节发育不良(DDH)患者髋臼形态的病理变化特点。方法笔者自2011-05—2015-03对53例(106髋)发育性髋关节发育不良患者进行MRI扫描检查,选取69髋为试验组,选取30例(30髋)双侧髋关节完全正常儿童为对照组,测量对照组及试验组髋关节的骨性髋臼指数(BAI)、软骨髋臼指数(CAI)、前骨性髋臼指数(ABAI)、前软骨性髋臼指数(ACAI)、后骨性髋臼指数(PBAI)、后软骨性髋臼指数(PCAI)、骨性髋臼前倾角(BAAV)、软骨性髋臼前倾角(CAAV),分析年龄与髋关节MRI测量指数的相关性、各组间MRI测量指数的差异及相关性特点。结果对照组年龄与BAI(r=-0.715)、CAI(r=-0.597)存在负相关;试验组BAI、CAI、ABAI、ACAI、BAAV、CAAV与对照组比较差异有统计学意义(P<0.05),其中BAI、CAI在试验组亚组中Ⅱ度、Ⅲ度与Ⅰ度之间差异有统计学意义(P<0.05),ABAI仅在试验组亚组Ⅰ度与Ⅲ度之间差异有统计学意义(P<0.05),ACAI、BAAV与CAAV在试验组诸亚组之间差异无统计学意义;试验组(r=0.384)及对照组(r=0.551)的BAI与CAI之间存在正相关。结论 MRI可以有效评价髋臼形态改变;髋臼软骨相对年龄变化更为稳定,评价髋关节形态更为准确;DDH患者髋臼骨性及软骨性缺损主要位于髋臼外上缘及前缘,软骨性改变与骨性改变相关而非完全同步。
Objective To investigate the pathological changes of the acetabular morphology in patients with developmental dysplasia of the hip (DDH) through MRI quantitative analysis. Methods From May 2011 to May 2015, 53 patients (106 hips) with dysplastic hip dysplasia underwent MRI scan. Totally 69 hips were selected as experimental group and 30 normal hip (30 hips) children (BAI), cartilage acetabular index (CAI), anterior acetabular index (ABAI), anterior cartilage acetabular index (ACAI) The posterior bony acetabular index (PBAI), posterior cartilage acetabular index (PCAI), bony acetabular ankle (BAAV), cartilage acetabular anteversion (CAAV), age of analysis were correlated with MRI measurements of the hip Sex, differences in MRI measurement index between groups and correlation characteristics. Results The age of the control group was negatively correlated with BAI (r = -0.715) and CAI (r = -0.597). The BAI, CAI, ABAI, ACAI, BAAV and CAAV in the experimental group were significantly different from those in the control group ), BAI, CAI in the test group subgroup Ⅱ degree, Ⅲ degree and Ⅰ degree difference was statistically significant (P <0.05), ABAI only in the test group subgroup Ⅰ and Ⅲ degrees difference between the statistics (P <0.05). There was no significant difference between ACA, BAAV and CAAV in all subgroups of test group. There was a positive correlation between BAI and CAI in test group (r = 0.384) and control group (r = 0.551) Related. Conclusion MRI can effectively evaluate the morphological changes of the acetabulum. The change of the relative age of the acetabular cartilage is more stable and the shape of the hip joint is more accurate. The acetabular bony and cartilage defects of the DDH are mainly located on the outer edge and the anterior edge of the acetabulum. Sexual changes associated with changes in bone rather than completely synchronized.