晚期髋关节结核髋臼骨破坏三维形态观察

发布时间：2018-11-06 08:21

【摘要】：[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(P0.05),前区、后区骨破坏容积大于下区骨破坏容积(P0.05),前区骨破坏容积与后区比较差异无统计学意义(P0.05)。[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。
[Abstract]:[objective] to study the three-dimensional characteristics of acetabular bone destruction in advanced hip tuberculosis. [methods] from November 2010 to December 2016, 73 patients with advanced tuberculosis of hip joint were diagnosed, 39 males and 34 females, with an average age of (47.95 卤16.61) (1985) years. All patients were performed pelvic volume scan with 320 rows of CT and 3 D pelvic reconstruction with Mimics software. Three dimensional structure of acetabular lesion was reduced by mirror image technique. The normal acetabular was set as standard hemispheres. The acetabular center was determined by spherical fitting technique. The acetabular lesion was divided into upper, anterior, inferior and posterior areas according to the labeled points. The normal acetabular volume, the total acetabular destruction volume and the bone destruction volume were calculated. The destruction volume of acetabular bone was converted to the percentage of normal acetabular volume. According to the percentage of bone destruction volume to acetabular volume, the degree of acetabular destruction was divided into 3 degrees, mild: 50; moderate: 50 ~ 100; severe: 100. Acetabular bone destruction was divided into 2 types according to the percentage of single area bone destruction to the total destroyed volume, diffuse type: 50 knuckle, segmental type: 鈮，

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