高频超声对发育性髋关节异常早期诊断的临床价值
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摘要
目的探讨高频超声对发育性髋关节异常(DDH)早期诊断的临床价值。方法选择我院2014年3月至2018年7月疑似DDH参加髋筛超声检查的1 594例新生儿及婴儿,均采用高频[(5.0～7.5)MHz]线阵超声检查,Graf法测量髋关节α角和β角并进行分析,参照Graf分类方法进行分型诊断。结果 1 594例(共计3 188个髋关节)受检新生儿及婴儿经超声检查,依照Graf分型标准,DDH检出率70例(4.39%);总共123个髋关节发生DDH,发生率3.86%。而且其中女性56例(6.59%,56/850),男性14例(1.88%,14/744),男女患儿发病率比较差异有统计学意义(P<0.05);左侧髋关节数91个(5.71%,91/1 594),右侧32个(2.01%,32/1 594),左侧发病率高于右侧(P<0.05)。按不同月龄分组后,DDH检出率、髓关节DDH阳性率以4～6月龄组最高,明显高于其余月龄组,但组间比较差异无统计学意义(P>0.05)。结论高频超声对婴幼儿DDH早期筛查具有较高的诊断价值,可为临床提供准确、全面的影像学参考资料。
Objective To study the clinical diagnosis value of high frequency ultrasound in the early developmental dysplasia of hip(DDH). Methods A total of 1 594 newborns and infants who were suspected of DDH from March2014 to July 2018 to take part in the hip sieves ultrasound examination were selected. High frequency [(5.0-7.5) MHz]linear array ultrasound is used to check. The Graf method was used to measure the alpha and beta angle of the hip joint,and the Graf classification method was used for the classification diagnosis. Results In 1 594 cases(3 188 hips),the newborns and infants were examined by ultrasonography. According to the Graf classification standard,the detection rate of DDH was 70 cases(4.39%),and the total 123 hips occurred DDH,the incidence rate was 3.86%. And 56 of them were female(6.59%,56/850),14 cases were male(1.88%,14/744),and the disease rate difference was statistically significant(P<0.05);The number of left hip joints was 91(5.71%,91/1 594),and 32 on the right(2.01%,32/1 594).The incidence of left side was significantly higher than that on the right side(P<0.05). According to different age groups,DDH detection rate and DDH positive rate were highest in 4-6 month group,significantly higher than those in other months,but there was no significant difference between groups(P>0.05). Conclusion High frequency ultrasound has a high diagnostic value for early screening of DDH in infants. It can provide accurate and comprehensive imaging reference for clinical practice.
Objective To study the clinical diagnosis value of high frequency ultrasound in the early developmental dysplasia of hip(DDH). Methods A total of 1 594 newborns and infants who were suspected of DDH from March2014 to July 2018 to take part in the hip sieves ultrasound examination were selected. High frequency [(5.0-7.5) MHz]linear array ultrasound is used to check. The Graf method was used to measure the alpha and beta angle of the hip joint,and the Graf classification method was used for the classification diagnosis. Results In 1 594 cases(3 188 hips),the newborns and infants were examined by ultrasonography. According to the Graf classification standard,the detection rate of DDH was 70 cases(4.39%),and the total 123 hips occurred DDH,the incidence rate was 3.86%. And 56 of them were female(6.59%,56/850),14 cases were male(1.88%,14/744),and the disease rate difference was statistically significant(P<0.05);The number of left hip joints was 91(5.71%,91/1 594),and 32 on the right(2.01%,32/1 594).The incidence of left side was significantly higher than that on the right side(P<0.05). According to different age groups,DDH detection rate and DDH positive rate were highest in 4-6 month group,significantly higher than those in other months,but there was no significant difference between groups(P>0.05). Conclusion High frequency ultrasound has a high diagnostic value for early screening of DDH in infants. It can provide accurate and comprehensive imaging reference for clinical practice.
引文
[1]Kosuge D,Yamada N,Azegami S,et al.Management of developmental dysplasia of the hip in young adults:current concepts[J].Bone Joint J,2013,95(6):732-737.
[2]汤莹,王莹莹,潘蕾,等.天津市10 262名婴儿髋关节超声筛查结果及相关因素分析[J].中国妇幼保健,2011,26(33):5177-5178.
[3]谢荣辉,殷明,贾惊宇.发育性髋关节脱位的遗传学研究进展[J].中国矫形外科杂志,2013,21(7):667-670.
[4]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].Comp Meth Prog Biomed,2016,129(C):89-98.
[5]Pruszczynski B,Harcke HT,Jr LH,et al.Natural history of hip instability in infants(without subluxation or dislocation):a three year follow-up[J].Bmc Musculo Disor,2014,15(1):1-7.
[6]刘廷会,陈俊,朱善良,等.高频超声在发育性髋关节异常早期诊断及随访中的临床价值[J].南京医科大学学报(自然科学版),2014,34(3):367-368.
[2]汤莹,王莹莹,潘蕾,等.天津市10 262名婴儿髋关节超声筛查结果及相关因素分析[J].中国妇幼保健,2011,26(33):5177-5178.
[3]谢荣辉,殷明,贾惊宇.发育性髋关节脱位的遗传学研究进展[J].中国矫形外科杂志,2013,21(7):667-670.
[4]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].Comp Meth Prog Biomed,2016,129(C):89-98.
[5]Pruszczynski B,Harcke HT,Jr LH,et al.Natural history of hip instability in infants(without subluxation or dislocation):a three year follow-up[J].Bmc Musculo Disor,2014,15(1):1-7.
[6]刘廷会,陈俊,朱善良,等.高频超声在发育性髋关节异常早期诊断及随访中的临床价值[J].南京医科大学学报(自然科学版),2014,34(3):367-368.