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目的 探讨螺旋CT及三维重建技术在发育性髋关节发育不良手术治疗中的应用。方法 收集病例 1 6例 ,患儿术前均接受X线、CT扫描和三维CT重建检查。比较三者的检查结果 ,结合术中所见 ,评价螺旋CT及三维重建技术在发育性髋关节不良手术治疗中的作用。结果 对比 1 6例髋脱位X线及CT扫描 ,三维CT重建资料 ,其中 9例X线与CT扫描、三维重建检查结果一致。但三维重建有 2例髋臼前上方缺损 (Ⅱ型 ) ,4例中上方缺损 (Ⅲ型 ) ,1例球型缺损 (Ⅳ型 ) ,X线片仅表现为股骨头脱位和髋臼发育不良。因此这 7例患儿更改了依据X线表现拟定的手术治疗方案。 2例行Salter骨盆旋转截骨术 ,3例行改良莎氏手术 ,2例行改良莎氏手术 +髋臼造架手术 ,依靠螺旋CT及三维重建技术的资料 ,术前可以辅助诊断 ,对治疗具有指导意义。结论 螺旋CT及三维重建技术能多方位、立体地显示髋关节的形态 ,对术者选择适当的治疗方案及手术入路 ,纠正前倾角及髋臼指数均具有重要的指导意义
Objective To investigate the application of spiral CT and three-dimensional reconstruction in the development of dysplastic hip dysplasia. Methods Totally 16 cases were collected. All patients underwent preoperative X-ray, CT scan and three-dimensional CT reconstruction. Compare the results of the three tests, combined with intraoperative findings, evaluate the role of spiral CT and three-dimensional reconstruction in the development of adverse surgical treatment of hip. Results Sixteen patients underwent X-ray and computed tomography (CT) scans and three-dimensional computed tomography reconstruction. Among them, 9 cases were consistent with CT scan and 3D reconstruction. However, there were 2 cases of anterior superior acetabular anterior defect (type Ⅱ), 4 cases of anterior superior defect (type Ⅲ), and 1 case of spherical defect (type Ⅳ) in 3D reconstruction. X-ray showed only dislocation of femoral head and acetabular dysplasia . Therefore, these 7 cases of children changed according to X-ray performance of the proposed surgical treatment. 2 cases of Salter pelvic rotation osteotomy, 3 cases of modified Shas operation, 2 cases of modified Shas operation + acetabular arthrodesis surgery, relying on spiral CT and three-dimensional reconstruction of the data, preoperative diagnosis and treatment can be It is instructive. Conclusions Spiral CT and three-dimensional reconstruction can show the shape of the hip multi-dimensionally and stereoscopically, and it is of great significance for the surgeon to choose appropriate treatment options and surgical approach, to correct the anteversion and acetabular index