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单次曝光改良Budin位X线片测量髋关节发育不良患者股骨前倾角的临床应用 认领

Clinical application of single-view radiographic modified Budin X-ray plain film for measurement of femoral anteversion in patients with developmental dysplasia of the hip
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摘要 目的探讨单次曝光改良Budin位X线片测量髋关节发育不良(DDH)患者股骨前倾角(FA)的临床可行性。方法前瞻性对照研究。纳入2018年6—12月解放军总医院第四医学中心关节外科拟行保髋治疗的22例DDH患者,其中男3例、女19例,年龄(25.8±7.2)岁。患者术前均行双侧髋关节改良Budin位X线摄片及CT扫描。在改良Budin位X线片上测量术前FA值,在CT影像上分别通过Yoshioka法和Suh法测量术前FA值。采用配对t检验,分别比较改良Budin位X线测量与CT扫描Yoshioka法和Suh法FA测量值的差异;分析Budin位X线片上FA测量结果与CT片上两种测量方法所测结果的相关性;采用组内相关系数(ICC),对改良Budin位X线FA测量值进行观察者自身及观察者间一致性检验。结果在改良Budin位X线片上观察者自身ICC为0.984,观察者间ICC为0.972,均有良好的一致性。改良Budin位X线片FA测量值为22.05°±12.29°,CT片上Yoshioka法和Suh法FA测量值分别为23.42°±14.64°和24.44°±14.53°,X线测量与后两者比较差异均无统计学意义(t=0.473、0.832,P值均>0.05)。相关性分析结果显示,改良Budin位X线测量与CT片上Yoshioka法和Suh法两种测量法的测量结果间相关性好(r=0.962、0.972,P值均<0.05)。结论拟接受保髋治疗的DDH患者可以应用单次曝光改良Budin位X线片对术前股骨前倾角进行评估。 Objective This study aims to explore the clinical feasibility of modified Budin X-ray plain film for measurement of femoral anterior(FA)in patients with developmental dysplasia of the hip(DDH).Methods This study adopted a prospective controlled design.From June to December 2018,22 patients with DDH(3 males and 19 females)with an average age of(25.8±7.2)years were recruited in the Fourth Medical Centers of PLA General Hospital for analysis.The patients underwent preoperative bilateral hip modified Budin plain and CT scan examination.FA measured on the modified Budin plain was compared with that measured on the CT scan by Yoshioka's and Suh's methods.To analyzed the correlation between the measurement results of the two imaging methods.Angle was measured by two independent examiners.Intra-and inter-observer reliabilities of each measurement were examined.Results In the modified Budin X-ray image,the interclass correlation coefficient(ICC)of the same surveyor was 0.984,and that of different subjects was 0.972,showing good consistency.The mean radiological measurement was 22.05°±12.29°,and the mean CT measurements were 23.42°±14.64°and 24.44°±14.53°(t=-0.473,-0.832,all P values>0.05).The intra-and interobserver reliabilities were excellent for all measurements.The radiological measurements correlated well with the CT measurements(r=0.962,0.972,all P values<0.05).Conclusions Modified Budin method appears reliable and valid for measurement of femoral stem anteversion in patients with DDH.
作者 马云青 张蔷 张洪 Ma Yunqing;Zhang Qiang;Zhang Hong(Department of Joint Surgery,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China)
出处 《中华解剖与临床杂志》 2020年第5期461-465,共5页 Chinese Journal of Anatomy and Clinics
关键词 髋脱位 发育性髋关节发育不良 股骨前倾角 放射摄影术 Hip Dislocation Developmental dysplasia of the hip Femoral anteversion Radiography
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