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[无症状人群及发育性髋关节发育不良患者髋臼三维方向的半自动测量与分析]

[Semi-automated measurement and analysis of three-dimensional acetabular orientation in asymptomatic population and patients of developmental dysplasia of the hip].

作者信息

Jiang Xu, Zhang Henghui, Hu Xumin, Xie Kai, Kan Tianyou, Li Bo, Zhang Chi, Ai Songtao, Gao Liangbin, Yan Mengning, Wang Liao

机构信息

Department of Orthopedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P.R.China.

Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou Guangdong, 510120, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Dec 15;35(12):1555-1562. doi: 10.7507/1002-1892.202107112.

Abstract

OBJECTIVE

To evaluate the three-dimensional acetabular orientation in asymptomatic population and patients of developmental dysplasia of the hip (DDH) using a semi-automated measurement software, which provides data for the differential diagnosis, surgical planning, surgical instrument design, and postoperative evaluation of hip related diseases.

METHODS

Eighty-four cases of CT data in asymptomatic population (asymptomatic group) and 47 cases of CT data in DDH patients (DDH group) were collected. There was no significant difference in gender and age (including age of male and female subgroups) between the two groups ( <0.05). MaxTHA, a semi-automatic measurement software, was used to measure acetabular inclination and anteversion, including operative inclination (OI), radiographic inclination (RI), anatomic inclination (AI), operative anteversion (OA), radiographic anteversion (RA), and anatomic anteversion (AA). Comparisons were made between the two populations, between different Crowe classification subgroups, between different gender subgroups, and between left and right sides of acetabula.

RESULTS

The comparison between asymptomatic group, healthy side of DDH group, and affected side of DDH group showed that there was no significant difference in acetabular orientation between asymptomatic group and healthy side of DDH group ( >0.05). The OI, RI, and AI of affected side of DDH group were significantly higher than those in healthy side of DDH group and asymptomatic group, and AA was significantly lower than that in healthy side of DDH group and asymptomatic group ( <0.05). The comparison between the normal acetabula and DDH acetabula with different Crowe classifications showed that there was no significant difference in the acetabulum orientation between Crowe Ⅰ group and the normal group ( >0.05). The OI, RI, and AI of Crowe Ⅱ, Ⅲ, and Ⅳ groups were significantly higher than those of normal group ( <0.05), the OI of Crowe Ⅲ group, RI and AI of Crowe Ⅳ group were significantly higher than those of Crowe Ⅰ group ( <0.05), the AI of Crowe Ⅳ group was significantly higher than that of Crowe Ⅱ group ( <0.05), and the OA, RA, and AA of Crowe Ⅲ group were significantly lower than other subgroups ( <0.05) except Crowe Ⅰ group. The OA, RA, and AA in asymptomatic female group, and the OA and AI in DDH female group were significantly higher than those in all male groups ( <0.05). The OI, RI, AI, and OA of the right acetabula in asymptomatic male group, and the RI and AI of the right acetabula in asymptomatic female group were significantly higher than those on the left side ( <0.05).

CONCLUSION

There were significant differences in acetabular orientation between asymptomatic and DDH populations, inter-group differences among Crowe classification subgroups, inter-gender differences among subgroups, and bilateral differences among asymptomatic individuals.

摘要

目的

使用半自动测量软件评估无症状人群及发育性髋关节发育不良(DDH)患者的髋臼三维方向,为髋关节相关疾病的鉴别诊断、手术规划、手术器械设计及术后评估提供数据。

方法

收集84例无症状人群的CT数据(无症状组)和47例DDH患者的CT数据(DDH组)。两组在性别和年龄(包括男性和女性亚组年龄)方面无显著差异(<0.05)。使用半自动测量软件MaxTHA测量髋臼倾斜度和前倾角,包括手术倾斜度(OI)、影像学倾斜度(RI)、解剖学倾斜度(AI)、手术前倾角(OA)、影像学前倾角(RA)和解剖学前倾角(AA)。对两组人群、不同Crowe分类亚组、不同性别亚组以及髋臼左右侧之间进行比较。

结果

无症状组、DDH组健康侧和患侧之间的比较显示,无症状组与DDH组健康侧的髋臼方向无显著差异(>0.05)。DDH组患侧的OI、RI和AI显著高于DDH组健康侧和无症状组,AA显著低于DDH组健康侧和无症状组(<0.05)。正常髋臼与不同Crowe分类的DDH髋臼之间的比较显示,CroweⅠ组与正常组的髋臼方向无显著差异(>0.05)。CroweⅡ、Ⅲ和Ⅳ组的OI、RI和AI显著高于正常组(<0.05),CroweⅢ组的OI、CroweⅣ组的RI和AI显著高于CroweⅠ组(<0.05),CroweⅣ组的AI显著高于CroweⅡ组(<0.05),CroweⅢ组的OA、RA和AA显著低于除CroweⅠ组外的其他亚组(<0.05)。无症状女性组的OA、RA和AA以及DDH女性组的OA和AI显著高于所有男性组(<0.05)。无症状男性组右侧髋臼的OI、RI、AI和OA以及无症状女性组右侧髋臼的RI和AI显著高于左侧(<0.05)。

结论

无症状人群与DDH人群之间、Crowe分类亚组间、亚组间性别差异以及无症状个体双侧之间的髋臼方向存在显著差异。

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Three-dimensional analysis of acetabular orientation using a semi-automated algorithm.使用半自动算法进行髋臼方位的三维分析。
Comput Assist Surg (Abingdon). 2019 Dec;24(1):18-25. doi: 10.1080/24699322.2018.1545872. Epub 2019 Jan 4.
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Acetabular orientation: anatomical and functional measurement.髋臼方位:解剖学和功能测量。
Int J Comput Assist Radiol Surg. 2012 Mar;7(2):233-40. doi: 10.1007/s11548-011-0648-3. Epub 2011 Aug 7.

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