临床小儿外科杂志2024，Vol.23Issue(10)：940-945,6.DOI:10.3760/cma.j.cn101785-202403002-008
MRI-骨性泪滴眉弓线预测发育性髋关节发育不良闭合复位后残余髋臼发育不良的研究
Application of MRI-Bony teardrop and sourcil line in predicting residual acetabular dysplasia after closed reduction of developmental dysplasia of the hip
摘要
Abstract
Objective To explore the feasibility of using magnetic resonance imaging(MRI)to measure the teardrop and sourcil line(TSL)for predicting the occurrence of residual acetabular dysplasia(RAD)after closed reduction(CR)in children with developmental dysplasia of the hip(DDH).Methods This study measured and recorded the continuity of the bony TSL and the maximum acetabular distance(AD)on MRI in 54 children,totaling 68 hips(40 unilateral cases and 14 bilateral cases)clinically diagnosed with DHH and who underwent CR.X-ray images were used to observe and record the acetabular index(AI)at the time of CR,as well as the International Hip Dysplasia Institute(IHDI)classification.According to the modified Severin classification,the affected hips were divided into RAD and non-RAD groups,and differences between the two groups were compared.Additionally,patients were categorized into MRI-bony TSL continuous and non-continu-ous groups to compare differences in indicators between these groups.The receiver operating characteristic curve(ROC)was used to evaluate the effectiveness of the AD difference in predicting the occurrence of RAD.Re-sults Among the 68 hips,2 were classified as Severin type Ⅰ,15 as type Ⅱ,46 as type Ⅲ,and 5 as type Ⅳ;51 hips in the RAD group,and 17 in the non-RAD group.Univariate analysis showed that IHDI classification,the continuity of the bony TSL,and the AD difference between the normal and affected sides were related factors for the occurrence of RAD after CR in DHH children.Multivariate logistic regression analysis revealed that IH-DI classification(OR=0.090,95％CI:0.010-0.794),MRI-bony TSL continuity(OR=0.015,95％CI:0.002-0.128),and AD difference between the normal and affected sides(OR=7.1×10 8,95％CI:370.6-1.4×10 15)were independent factors influencing the occurrence of RAD after CR in DHH children(P＜0.05).ROC curve analysis showed that the difference between normal side and affected side AD predicted the onset of RAD by 0.31cm,corresponding sensitivity and specificity were 0.900 and 0.833,respectively,and AUC was 0.917.Conclusions IHDI classification,MRI-bony TSL continuity,and the AD difference between the normal and affected sides can serve as indicators for predicting RAD occurrence after CR in DDH children.Compared to X-ray TSL,MRI-bony TSL can predict the occurrence of RAD earlier and more accurately.关键词
发育性髋关节发育不良/残余髋臼发育不良/外科手术/儿童Key words
Developmental Hip Dysplasia/Residual Acetabular Dysplasia/Surgical Procedures,Op-erative/Child引用本文复制引用
裴胤志,黄鹏,吴春星,宁波..MRI-骨性泪滴眉弓线预测发育性髋关节发育不良闭合复位后残余髋臼发育不良的研究[J].临床小儿外科杂志,2024,23(10):940-945,6.基金项目
国家自然科学基金(82272441) （82272441）
上海市科学技术委员会科技创新行动计划(22Y11912200) National Natural Science Foundation of China(82272441) （22Y11912200）
Science and Technology In-novation Action Plan of Shanghai Science and Technology Committee(22Y11912200) （22Y11912200）
