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磁共振成像评估发育性髋关节发育不良的不可还原方面。

Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging.

机构信息

Department of Radiology, Children's Hospital of Soochow University, Suzhou, 215000, PR China.

Department of Orthopaedics, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou, 215000, PR China.

出版信息

BMC Pediatr. 2020 Dec 5;20(1):550. doi: 10.1186/s12887-020-02420-2.

Abstract

BACKGROUND

The developmental dysplasia of the hip (DDH) can cause a wide range of pathological changes, and often requires surgical treatment. Preoperative evaluation is very important for DDH. We aimed to assess the diagnostic capability of magnetic resonance imaging (MRI) for irreducible aspects preventing hip reduction in DDH.

METHODS

A total of 39 pediatric patients who received DDH evaluation in pediatric orthopedics from January 2015 to December 2019 were included. The samples included 4 cases of bilateral DDH and 35 cases of unilateral DDH, a total of 43 hip joint samples. All patients underwent surgical treatment, pathological examination and MRI of hip joint.

RESULTS

With pathological results or intraoperative findings as the gold standard, the sensitivity and specificity of MRI were 90.3% and 83.3% for the affected labrum, 92% and 83.3% for thickening of the round ligament, 90.0% and 91.3% for atrophy of the iliopsoas muscle, and 100% and 100% for fibrofatty pulvinar tissue and joint effusion, respectively.

CONCLUTIONS

The MRI showed an extraordinary capability of detecting these irreducible factors and helped surgeon choose the appropriate treatment strategies.

摘要

背景

发育性髋关节发育不良(DDH)可引起广泛的病理变化,常需手术治疗。术前评估对 DDH 非常重要。我们旨在评估磁共振成像(MRI)对防止 DDH 髋关节复位的不可还原方面的诊断能力。

方法

共纳入 2015 年 1 月至 2019 年 12 月在小儿矫形外科接受 DDH 评估的 39 例儿科患者。样本包括双侧 DDH4 例,单侧 DDH35 例,共 43 个髋关节样本。所有患者均接受手术治疗、髋关节病理检查和 MRI 检查。

结果

以病理结果或术中发现为金标准,MRI 对病变盂唇的敏感度和特异度分别为 90.3%和 83.3%,对圆韧带增厚的敏感度和特异度分别为 92%和 83.3%,对髂腰肌萎缩的敏感度和特异度分别为 90.0%和 91.3%,对纤维脂肪隆突组织和关节积液的敏感度和特异度分别为 100%和 100%。

结论

MRI 显示出检测这些不可还原因素的非凡能力,有助于外科医生选择合适的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5933/7718709/a92f82e8a93a/12887_2020_2420_Fig1_HTML.jpg

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