应用CT三维重建评价发育性髋关节脱位儿童的髋关节形态特征

发布时间：2018-05-17 15:45

本文选题：骨疾病 + 发育性　；参考：《中国组织工程研究》2017年07期

【摘要】：背景:发育性髋关节脱位患儿的髋关节发育情况一直沿用骨盆X射线平片进行评价,主要观察沈通氏线是否连续及骨骺核的位置,尚缺乏量化和客观的评价方法。目的:应用CT三维重建坐标系构建发育性髋关节脱位患儿的髋关节三维重建数字化模型,精确量化髋关节旋转中心,从而用于准确评价脱位程度。方法:收集2010年12月至2014年12月在华中科技大学附属同济医院行CT检查的单侧发育性髋关节脱位患儿,其中CT影像学资料可获取者有16例,男4例,女12例;平均年龄(4.42±2.59)岁;左侧10例,右侧6例;所有CT资料经过三维重建分析处理构建3D数字化模型,采用逆向工程软件建立三维重建坐标系,并在三维坐标系中采用球体拟合工程逆向求解方法构建髋臼的旋转中心、股骨头的旋转中心以及骨化半径,计算骨化半径比和脱位距离。结果与结论:(1)健侧髋臼旋转中心点与股骨头旋转中心点重合,其X轴、Y轴和Z轴坐标差异无显著性意义(Px0.05,Py0.05,Pz0.05),患侧髋臼旋转中心与股骨头旋转中心不相重合,差异有显著性意义(Px=0.052,Py0.05,Pz0.05);(2)健侧髋臼与患侧髋臼的骨化半径差异无显著性意义(P0.05);健侧股骨头与患侧股骨头的骨化半径分别(21.37±4.42)mm和(20.14±3.14)mm,差异有显著性意义(P0.05);(3)健侧骨化半径比和患侧骨化半径比分别为0.544±0.069和0.522±0.088,差异无显著性意义(P0.05);(4)患侧髋关节的脱位距离为8.64-35.28 mm,平均(19.47±7.84)mm;(5)结果表明,应用CT三维重建可以构建发育性髋关节脱位患儿的髋关节3D数字化模型,并可以据此准确构建髋关节的旋转中心点,进而能够准确测量髋关节脱位距离。
[Abstract]:Background: the developmental development of hip joint in children with developmental dislocation of hip has been evaluated by pelvic X-ray plain film. It is lack of quantitative and objective evaluation method to observe whether Shen Tong's line is continuous and the position of epiphyseal nucleus. Objective: to establish a digital model of developmental dislocation of the hip in 3D reconstruction coordinate system of CT, and to quantify the rotation center of the hip accurately, so as to evaluate the degree of dislocation accurately. Methods: from December 2010 to December 2014, 16 children with unilateral developmental dislocation of hip underwent CT examination in Tongji Hospital affiliated to Huazhong University of Science and Technology. The CT imaging data were obtained in 16 cases (male 4, female 12; mean age 4.42 卤2.59). All CT data were analyzed by 3D reconstruction to construct 3D digital model, and 3D reconstruction coordinate system was established by reverse engineering software. The rotation center of acetabular, the rotation center of femoral head and ossification radius were constructed in 3D coordinate system. The ratio of ossification radius and dislocation distance were calculated. Results and conclusion (1) the acetabular rotation center of the contralateral side coincided with the rotation center point of the femoral head. There was no significant difference in the coordinates of X axis Y axis and Z axis. There was no significant difference between the X axis Y axis and Z axis coordinate. The acetabular rotation center of the affected side did not coincide with the femoral head rotation center. There was no significant difference in the ossification radius between the healthy side acetabular and the affected side acetabular, the ossification radius of the healthy side femoral head and the affected side femoral head were 21.37 卤4.42)mm and 20.14 卤3.14 mm, respectively. The ratio of ossification radius of the affected side was 0.544 卤0.069 and 0.522 卤0.088, respectively. There was no significant difference in the dislocation distance of the affected hip joint (8.64-35.28 mm, mean 19.47 卤7.84 mm). Three-dimensional CT reconstruction can be used to construct 3D digital model of hip joint in children with developmental dislocation of hip, and the rotation center point of hip joint can be accurately constructed according to this model, and the distance of dislocation of hip joint can be measured accurately.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;华中科技大学同济医学院附属同济医院小儿外科;
【分类号】：R726.8;R816.92

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