中国组织工程研究

中国组织工程研究 ›› 2020, Vol. 24 ›› Issue (30): 4875-4881.doi: 10.3969/j.issn.2095-4344.2837

• 骨与关节综述 bone and joint review • 上一篇    下一篇

儿童发育性髋关节发育不良解剖学改变与影像学表现

刘君艳，潘诗农   

  1. 中国医科大学附属盛京医院放射科，辽宁省沈阳市  110004
  • 收稿日期:2020-01-17 修回日期:2020-02-20 接受日期:2020-03-25 出版日期:2020-10-28 发布日期:2020-09-22
  • 通讯作者: 潘诗农，博士，教授，中国医科大学附属盛京医院放射科，辽宁省沈阳市 110004
  • 作者简介:刘君艳，1995年生，湖北省荆门市人，中国医科大学在读硕士，主要从事骨肌系统影像诊断与运动医学研究。

Anatomical changes and imaging manifestations of childhood developmental dysplasia of the hip

Liu Junyan, Pan Shinong   

  1. Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
  • Received:2020-01-17 Revised:2020-02-20 Accepted:2020-03-25 Online:2020-10-28 Published:2020-09-22
  • Contact: Pan Shinong, MD, Professor, Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
  • About author:Liu Junyan, Master candidate, Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China

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摘要：

文题释义：

发育性髋关节发育不良(developmental dysplasia of the hip，DDH)：又称发育性髋关节脱位，是常见的儿童髋关节发育畸形，发病率在1%左右。DDH特征是髋臼浅、股骨头覆盖不足和关节内负荷异常，导致关节脱位的风险增加，其病因尚不明确，目前认为与髋关节的骨骼、血管及其软组织结构改变都可能相关。

MR灌注成像：动态磁敏感增强灌注成像(DSCPWI)最先用于脑部，顺磁性对比剂高压注射后，以2 mL/s或更快速率，对10-13层，反复成像，观察对比剂通过组织信号变化情况，忽略T1效应，则T2WI的信号强度变化率与局部对比剂浓度成正比，与脑血容量成正比。连续测量，产生时间-信号强度曲线，分析曲线、对每个像素积分运算得到rcBV、rcBF、MTT、TTP图及Ktrans等定量参数。PWI可早期发现急性脑缺血灶，观察血管形态和血管化程度评价颅内肿瘤的不同类型。

背景：发育性髋关节发育不良是常见的儿童髋关节发育畸形，该病不同时期的治疗效果不同，早期治疗疗效较好，并发症较少，远期的预后更好，可以减少复发率，减轻经济压力，提高生活质量，所以，临床上对发育性髋关节发育不良的早期诊断越来越重要。

目的：对发育性髋关节发育不良的解剖学改变及影像学表现的研究进展进行综述。

方法：以“DDH，Anatomy，X-ray Radiography，CT，MRI，Ultrasound”为英文检索词，“发育性髋关节发育不良，解剖，X线摄影，CT，MRI，超声”为中文检索词，对PubMed、Springerlink等英文数据库及万方、CNKI等中文数据库进行检索，检索时限为1990年1月至2019年12月，排除与文章研究目的无关及重复性研究，纳入符合标准的55篇文献进行综述。

结果与结论：影像学诊断作为一种无创性的检查手段，已经成为诊断发育性髋关节发育不良首选的检查方法，而明确其解剖学改变更有助于临床影像学诊断，常规X射线片能够进行发育性髋关节发育不良的快速筛查；MRI有助于分辨软组织结构以及骨性结构早期信号改变；三维CT能够多角度评价髋臼骨性结构改变，排除了体位因素造成的遮挡；超声同样能够进行发育性髋关节发育不良筛查，并对关节积液更加敏感。所以，不同的影像学检查各有优势，相辅相成，提高发育性髋关节发育不良的早期诊断率。

ORCID: 0000-0003-4237-2614(刘君艳)

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 影像, 发育性髋关节发育不良, 解剖, X线摄影, CT, MRI, 超声, 综述

Abstract:

BACKGROUND: Developmental dysplasia of the hip is a common hip developmental deformity in children.

Clinical treatment of developmental dysplasia of the hip differs in different periods. Early treatment has better efficacy, fewer complications, and better long-term prognosis. It can reduce the recurrence rate, reduce economic pressure, and improve the quality of life. Therefore, early diagnosis of developmental dysplasia of the hip is becoming more and more important clinically.

OBJECTIVE: To review the research progress of anatomical changes and imaging manifestations of developmental dysplasia of the hip.

METHODS: “DDH, Anatomy, X-ray Radiography, CT, MRI, Ultrasound” were used as English search terms. “Developmental hip dysplasia; anatomy; X-ray photography; CT; MRI, ultrasound” were used as Chinese search terms. The authors searched English databases such as PubMed and Springerlink, and Chinese databases such as Wanfang and CNKI from January 1990 to December 2019. Irrelevant and repetitive articles were excluded, and finally 55 articles were included for review.

RESULTS AND CONCLUSION: Imaging diagnosis as a non-invasive examination method has become the preferred examination method for the diagnosis of developmental dysplasia of the hip, and its anatomical changes are more conducive to clinical imaging diagnosis. Routine X-ray examination can be used for rapid screening of developmental dysplasia of the hip. MRI helps to distinguish the early signal changes of soft tissue structure and bony structure. Three-dimensional CT can evaluate the acetabular bone structure changes from multiple angles, excluding the obstruction caused by posture factors. Ultrasonography is more sensitive to fluid and can also perform early screening of developmental dysplasia of the hip. Thus, different imaging examinations have their advantages and complement each other to improve the early diagnosis rate of developmental dysplasia of the hip.

Key words: imaging, developmental dysplasia of the hip, anatomy, X-ray radiography, CT, MRI, ultrasonography, review

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