摘要
背景:全髋关节置换过程中髋臼假体放置是否准确对患者术后髋关节功能、稳定性及使用寿命有直接影响,臼杯位置安放不合理可能导致不良事件发生,因此应重视CT影像学检查。目的:分析CT图像以水平面和真骨盆平面作为参照的髋关节置换髋臼相关参数的差异,明确其对治疗效果可能产生的影响。方法:选择72例患盆腔软组织疾病但髋关节正常者作为观察对象,所有患者对测量方案均知情同意,且得到医院伦理委员会批准。于自然平卧位下基于垂直水平面予以CT扫描,通过CT定位片及其扫描图像对双侧髋臼的前倾角、髋臼角、髋臼深度、髋臼宽度、股骨头中点一髋臼边缘角、外展角予以测量,同时对真骨盆平面与水平面间的夹角予以测量。选取CT软件予以三维重建,再次于真骨盆平面垂直予以扫描,采用相同方式对上述参数予以测量。左右侧髋臼及2个平面下参数的差异采用配对t检验进行比较,对2个参考平面的夹角与所测量参数的差值予以Spearman相关性分析。结果与结论:①水平面与真骨盆平面上的左右侧髋臼参数值差异无显著性意义(P>0.05);②骨盆倾斜角度与两参照面间股骨头中点-髋臼边缘角、髋臼前倾角差值呈正相关,与髋臼角、髋臼深度呈负相关;③提示平卧位CT扫描过程中,骨盆伴有旋转状况,以真骨盆平面作为参考的参数与直接测量得到的髋臼参数有误差,因此全髋关节换前制定髋臼假体放置方案时应引起重视。
BACKGROUND:The accuracy of acetabular prosthesis placement during total hip arthroplasty has a direct effect on postoperative hip function,stability and service life.Unreasonable placement of the cup may lead to adverse events,so CT imaging should be emphasized.OBJECTIVE:To analyze the differences of acetabular parameters in hip arthroplasty between the horizontal and true pelvic planes on CT images,and to determine the possible impact on surgery outcomes.METHODS:Seventy-two cases of pelvic soft tissue disease were selected.All patients signed the informed consents,and the study was approved by the hospital ethics committee.The anteversion angle,acetabular angle,acetabular depth,acetabular width,femoral head midpoint-acetabular margin angle,abduction angle between the true pelvic plane and the horizontal plane were masured by CT positioning film and its scanning image.CT software was selected to reconstruct the three-dimensional image,and then scanned vertically with the true pelvic plane.The above parameters were measured in the same way.The differences of parameters between left and right acetabulum and two planes were compared by paired t test.Spearman correlation analysis was used to analyze the correlation between the angles between the two reference planes and the difference between the measured parameters.RESULTS AND CONCLUSION:(1) There was no significant difference in the values of the left and right acetabular parameters between the horizontal plane and the true pelvic plane(P> 0.05).(2) The pelvic tilt angle was positively correlated with the femoral head midpoint-acetabular margin angle and the acetabular anteversion angle between the two reference surfaces,and negatively correlated with the acetabular angle and acetabular depth.(3) Our results suggest that during the CT scan of the supine position,the pelvis is accompanied by a rotation condition.The parameters of the true pelvis plane as a reference are inaccurate with the directly measured acetabular parameters.Therefore,attention should be paid to the preparation of the surgical plan before surgery.
作者
邓必勇
邓必祥
Deng Biyong;Deng Bixiang(Department of Orthopedics,Guizhou Province Osteological Hospital,Guiyang 550002,Guizhou Provinee,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第9期1405-1409,共5页
Chinese Journal of Tissue Engineering Research
基金
贵州省科技计划项目(黔科合[2017]1093),项目负责人:邓必勇~~
关键词
髋臼
髋关节
CT
真骨盆平面
成像
acetabulum
hip joint
CT
true pelvic plane
imaging
