发育性髋关节发育不良IHDI分型与MRI病理形态的相关性

发布时间：2018-11-11 11:43

【摘要】：背景:T?nnis分型是发育性髋关节发育不良脱位程度的常用分型方法,但其应用受股骨头骨骺核是否骨化的限制。针对这一缺点,国际髋关节发育不良协会(International Hip Dysplasia Institute,IHDI)提出了新的分型方法(IHDI分型),但IHDI分型与相对应的发育性髋关节发育不良病理改变如何,尚无报道。目的:分析IHDI分型与髋关节MRI病理形态的相关性。方法:回顾性分析发育性髋关节发育不良患儿的术前影像资料共65例(89髋),平均年龄20.4个月。按IHDI标准进行分型,并在MRI图像上,观察头臼关系、盂唇的形态,并测量软骨性髋臼指数,分析IHDI分型与髋关节病理形态的相关性。结果与结论:(1)IHDI分型与年龄呈正相关(r=0.456,P0.001);(2)随IHDI分型的增加,头臼关系由部分形成关节逐渐过度到完全不形成关节,软骨髋臼指数也明显增大(P=0.028);(3)Ⅰ型髋盂唇均为外翻形,而内翻或骑跨形的盂唇在Ⅱ型髋中占60%,Ⅲ型中占86%,Ⅳ型髋为97%;(4)结果表明,发育性髋关节发育不良随IHDI分型的增加,头臼间的覆盖率逐渐减小,软骨性髋臼缘发育不良及盂唇内翻程度逐渐加重。了解IHDI分型与髋关节病理形态的相关性对指导发育性髋关节发育不良治疗具有重要意义。
[Abstract]:Background: T?nnis classification is a common method for the classification of developmental dysplasia of hip, but its application is limited by whether the femoral head epiphyseal nucleus is ossified or not. In order to overcome this shortcoming, the International Association of Hip dysplasia (International Hip Dysplasia Institute,IHDI) proposed a new classification method (IHDI classification), but there is no report on the pathological changes between IHDI classification and the corresponding developmental hip dysplasia. Objective: to analyze the correlation between IHDI classification and MRI histopathology of hip joint. Methods: the preoperative imaging data of 65 cases (89 hips) with developmental dysplasia of hip were retrospectively analyzed, with an average age of 20.4 months. According to IHDI criteria, the relationship between head and labium and the shape of labium were observed on MRI images. The articular acetabular index was measured, and the correlation between IHDI classification and pathological morphology of hip was analyzed. Results and conclusion: (1) there was a positive correlation between IHDI classification and age (r = 0.456P 0.001); (2) with the increase of IHDI classification, the acetabular relationship between the head and the acetabulum increased gradually from partial joint formation to no joint formation, and the acetabular index of cartilage increased significantly (P0. 028). (3) the pelvic lips of type 鈪，

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