Chlapoutakis Konstantinos, Raissaki Maria, Markatzinou Styliani, Skoulikaris Nikolaos, Galanos Antonios, Hatzidakis Adam, Prassopoulos Panagiotis
Radiology, Vioapeikonisi Imaging Laboratory and Asklepieon Medical Clinic, Heraklion, Greece.
School of Medicine, University of Crete, Heraklion, Greece.
J Ultrason. 2024 Feb 7;24(94):1-7. doi: 10.15557/jou.2024.0003. eCollection 2024 Feb.
To investigate whether linear measurements or ratios on the Graf's "standard plane" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips.
A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf. Anatomical landmarks including the lower limb of the os ilium, the bony rim, the silhouette of the os ilium, the labrum and the femoral head's borders, were used to determine the measurements and ratios which quantified their inter-relationships.
The indices which differed significantly between type I and type II hips included: (a) the width of the "bony roof" (cut-off value 5.91 mm, sensitivity: 75%, specificity: 70%), (b) the ratio of the width of the "bony roof" to the femoral head's width (cut-off value 0.40, sensitivity 83%, specificity 71%), and (c) the ratio of the cartilaginous acetabular roof's width (including the labrum), to the width of the femoral head (cut-off value 0.450, sensitivity 82%, specificity 67%).
Newly introduced measurements and calculated ratios on "standard plane" ultrasound images can be used as additional indices in the differentiation between Graf's types of "centered hips", thus increasing the diagnostic certainty of the examiner in borderline cases and limiting unnecessary re-examinations or treatment.
研究新生儿/婴幼儿髋关节Graf“标准平面”超声图像上的线性测量值或比值，能否有助于临床上对I型和II型髋关节进行重要区分。
通过我们的髋关节筛查服务，在两年时间内，共识别出60例Graf II型髋关节和124例随机选取的Graf I型髋关节，这些髋关节在分娩时的孕周、出生体重、分娩方式以及检查时的年龄方面相互匹配。根据Graf的标准，经解剖结构识别和可用性检查后，这些图像具有诊断适用性。利用包括髂骨下肢、骨边缘、髂骨轮廓、盂唇和股骨头边界等解剖标志来确定测量值和比值，以量化它们之间的相互关系。
I型和II型髋关节之间存在显著差异的指标包括：（a）“骨顶”宽度（临界值5.91mm，敏感性：75%，特异性：70%），（b）“骨顶”宽度与股骨头宽度的比值（临界值0.40，敏感性83%，特异性71%），以及（c）软骨髋臼顶宽度（包括盂唇）与股骨头宽度的比值（临界值0.450，敏感性82%，特异性67%）。
在“标准平面”超声图像上新引入的测量值和计算出的比值，可作为区分Graf型“中心性髋关节”的附加指标，从而提高检查者在临界病例中的诊断确定性，并减少不必要的复查或治疗。
