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超声与磁共振成像对小儿发育性髋关节发育不良的诊断价值

王娜 关步云 张遇乐 肖伟强 朱莉玲 贺雪华 王雨润

王娜, 关步云, 张遇乐, 肖伟强, 朱莉玲, 贺雪华, 王雨润. 超声与磁共振成像对小儿发育性髋关节发育不良的诊断价值[J]. 分子影像学杂志, 2017, 40(2): 133-136. doi: 10.3969/j.issn.1674-4500.2017.02.03
引用本文: 王娜, 关步云, 张遇乐, 肖伟强, 朱莉玲, 贺雪华, 王雨润. 超声与磁共振成像对小儿发育性髋关节发育不良的诊断价值[J]. 分子影像学杂志, 2017, 40(2): 133-136. doi: 10.3969/j.issn.1674-4500.2017.02.03
Na WANG, Buyun GUAN, Yule ZHANG, Weiqiang XIAO, Liling ZHU, Xuehua HE, Yurun WANG. Diagnostic value of ultrasound and magnetic resonance imaging in children with developmental dysplasia of the hip[J]. Journal of Molecular Imaging, 2017, 40(2): 133-136. doi: 10.3969/j.issn.1674-4500.2017.02.03
Citation: Na WANG, Buyun GUAN, Yule ZHANG, Weiqiang XIAO, Liling ZHU, Xuehua HE, Yurun WANG. Diagnostic value of ultrasound and magnetic resonance imaging in children with developmental dysplasia of the hip[J]. Journal of Molecular Imaging, 2017, 40(2): 133-136. doi: 10.3969/j.issn.1674-4500.2017.02.03

超声与磁共振成像对小儿发育性髋关节发育不良的诊断价值

doi: 10.3969/j.issn.1674-4500.2017.02.03
详细信息
    作者简介:

    王娜:王  娜,硕士,主治医师,E-mail: 423352651@qq.com

Diagnostic value of ultrasound and magnetic resonance imaging in children with developmental dysplasia of the hip

  • 摘要: 目的 以磁共振成像(MRI)对小儿发育性髋关节发育不良(DDH)诊断结果为参考,探讨超声对DDH的诊断价值。 方法 对117例DDH患儿的117个髋关节进行超声和MRI检查,对比超声和MRI对DDH患儿髋关节病变检出的一致性,并对病变程度进行分型,比较两者对病变程度诊断的一致性,最后比较超声和MRI对不同年龄诊断的一致性。 结果 超声和MRI两种方法对DDH患儿髋关节的骨性结构(髂骨、髋臼骨顶、股骨头)病变检出的一致性好(K=0.901-0.885,P<0.001),对髋臼软骨顶病变检出的一致性差(K=0.093,P=0.151),对髋臼盂唇病变检出的一致性差(K=0.188,P=0.108),对关节囊病变检出的一致性差(K=0.201,P=0.095)。超声和MRI对发育不良(GrafⅡa型、Ⅱb型与MRIⅠ型)的髋关节检出的一致性好(K=0.963,P<0.001),对完全脱位(GrafⅢ型、Ⅳ型与MRIⅢ型)的髋关节检出的一致性好(K=0.897,P<0.001),对不完全脱位(GrafⅡc型、D型与MRIⅡ型)的髋关节检出的一致性差(K=0.152,P=0.093)。超声和MRI对年龄≤6个月的DDH患儿检出的一致性好(K=0.819,P<0.001),对年龄>6个月的DDH患儿检出的一致性差(K=0.136,P=0.202)。 结论 超声对于早期DDH的检出具有重要意义,有利于随访观察以及指导临床治疗。

     

  • 图  1  DDH不同分型超声图像

    图  2  DDH不同分型MRI图像

    表  1  超声与MRI诊断DDH阳性结果检出的一致性

    检查方法 骨性结构 软骨性结构及软组织
    髂骨 髋臼骨顶 股骨头 髋臼软骨顶 髋臼盂唇 关节囊
    超声 10 97 105 83 112 107
    MRI 108 102 109 37 89 79
    K 0.901 0.885 0.891 0.093 0.188 0.201
    P <0.001 <0.001 <0.001 0.151 0.108 0.095
    下载: 导出CSV
  • [1] Kotlarsky P, Haber R, Bialik V, et al. Developmental dysplasia of the hip: What has changed in the last 20 years?[J]. World J Orthop, 2015, 6(11): 886-901. doi: 10.5312/wjo.v6.i11.886
    [2] Williams D, Protopapa E, Stohr K, et al. The most relevant diagnostic criteria for developmental dysplasia of the hip: a study of British specialists[J]. BMC Musculoskelet Disord, 2016, 17(6): 38-43.
    [3] Sarkissian EJ, Sankar WN, Zhu XW, et al. Radiographic follow-up of DDH in infants: are x-rays necessary after a normalized ultrasound?[J]. J Pediatr Orthop, 2015, 35(6): 551-5. doi: 10.1097/BPO.0000000000000326
    [4] Querol F, Rodriguez-Merchan EC. The role of ultrasonography in the diagnosis of the musculo-skeletal problems of haemophilia[J]. Haemophilia, 2012, 18(3): e215-26. doi: 10.1111/hae.2012.18.issue-3
    [5] Ashby E, Roposch A. Diagnostic yield of sonography in infants with sus-pected hip dysplasia: diagnostic thinking efficiency and therapeutic efficiency[J]. AJR Am J Roentgenol, 2015, 204(1): 177-81. doi: 10.2214/AJR.14.12477
    [6] Hareendranathan AR, Mabee M, Punithakumar K, et al. Toward automated classification of acetabular shape in ultrasound for diagnosis of DDH: Contour alpha angle and the rounding index[J]. Comput Methods Programs Biomed, 2016, 129(8): 89-98.
    [7] Karnik AS, Karnik A, Joshi A. Ultrasound examination of pediatric muscu-loskeletal diseases and neonatal spine[J]. Indian J Pediatr, 2016, 83(6): 565-77. doi: 10.1007/s12098-015-1957-2
    [8] Kyung BS, Lee SH, Jeong WK, et al. Disparity between Clinical and Ultrasound Examinations in Neonatal Hip Screening[J]. Clin Orthop Surg, 2016, 8(2): 203-9. doi: 10.4055/cios.2016.8.2.203
    [9] Graf R, Scott. Hip sonography: diagnosis and management of infant hip dysplasia[M]. 2nd ed, Springer, 2006.
    [10] Dunn PM. The anatomy and pathy of congenital dislocation of the hip[J]. Clin Orthop, 1976, 11(9): 23-7.
    [11] Lee J, Spinazzola RM, Kohn N, et al. Sonographic screening for developmental dysplasia of the hip in preterm breech infants: do current guidelines address the specific needs of premature infants?[J]. J Perinatol, 2016, 36(7): 552-6. doi: 10.1038/jp.2016.7
    [12] 陈文娟, 段星星, 李 皓, 等. 高频超声对疑似发育性髋关节异常患儿髋关节发育的评估价值[J]. 临床小儿外科杂志, 2011, 10(5): 345-7. http://www.cnki.com.cn/Article/CJFDTOTAL-BTYX201704027.htm
    [13] Mace J, Paton RW. Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study[J]. Bone Joint J, 2015, 97-B(2): 265-9. doi: 10.1302/0301-620X.97B2.34858
    [14] Laborie LB, Markestad TJ, Davidsen H, et al. Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991-2006[J]. Pediatr Radiol, 2014, 44(4): 410-24. doi: 10.1007/s00247-013-2838-3
    [15] Kumar RK, Shah P, Ramya AN, et al. Diagnosing developmental dysplasia of hip in newborns using clinical screen and ultrasound of Hips-An Indian experience[J]. J Trop Pediatr, 2016, 62(3): 241-5. doi: 10.1093/tropej/fmv107
    [16] Wicart P, Bocquet A, Gelbert N, et al. Congenital dislocation of the hip: Optimal screening strategies in 2014[J]. Orthop Traumatol Surg Res, 2014, 100(6): S339-47. doi: 10.1016/j.otsr.2014.08.001
    [17] Burnei G. Eradicating developmental dislocation of the hip: a National program in Romania using the Graf method of ultrasound examination[J]. Med Ultrason, 2014, 16(4): 391-2.
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出版历程
  • 收稿日期:  2016-12-09
  • 刊出日期:  2017-04-01

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