CAJ | 학술논문

背景：超声检查已广泛应用于婴幼儿发育性髋关节发育不良的筛查，但有报道指出，在不同的检查者之间检查结果存在显著差异，即使在同一检查者的重复检查中也会存在偏差，因此认为超声在诊断成像准确性方面证据不足。 　　目的：通过三维重建虚拟现实图像显示髋臼及股骨头的空间立体结构，获得一个新的参数，从而丰富Graf超声诊断技术的测量标准，进一步增强髋关节发育不良诊断结果的可信度。 　　方法：选取国人婴幼儿新鲜尸体标本10具(男性5具，女性5具)，应用Graf二维超声法对髋关节扫查，并同时行多排螺旋CT三维重建，再将容积重建与表面重建拟合，显示髋关节周围解剖结构，模拟Graf二维超声法对三维虚拟现实图像进行a角和β角的测量。 　　结果与结论：通过三维重建虚拟现实图像对二维Graf方法测量的验证，证实二维Graf方法测量α角和β角可以真实反映骨性髋臼和软骨髋臼的发育情况。Graf二维超声技术可对新生儿髋关节发育状况做出正确评价，可以将Graf二维超声法作为髋关节发育不良的常规检查。说明熟练掌握Graf超声检查技术和严格掌握髋关节发育不良评判标准是髋关节发育不良诊断的重要保障。
배경：초성검사이엄범응용우영유인발육성관관절발육불량적사사，단유보도지출，재불동적검사자지간검사결과존재현저차이，즉사재동일검사자적중복검사중야회존재편차，인차인위초성재진단성상준학성방면증거불족。 　　목적：통과삼유중건허의현실도상현시관구급고골두적공간입체결구，획득일개신적삼수，종이봉부Graf초성진단기술적측량표준，진일보증강관관절발육불량진단결과적가신도。 　　방법：선취국인영유인신선시체표본10구(남성5구，녀성5구)，응용Graf이유초성법대관관절소사，병동시행다배라선CT삼유중건，재장용적중건여표면중건의합，현시관관절주위해부결구，모의Graf이유초성법대삼유허의현실도상진행a각화β각적측량。 　　결과여결론：통과삼유중건허의현실도상대이유Graf방법측량적험증，증실이유Graf방법측량α각화β각가이진실반영골성관구화연골관구적발육정황。Graf이유초성기술가대신생인관관절발육상황주출정학평개，가이장Graf이유초성법작위관관절발육불량적상규검사。설명숙련장악Graf초성검사기술화엄격장악관관절발육불량평판표준시관관절발육불량진단적중요보장。
BACKGROUND:Ultrasound has been widely used in developmental hip dysplasia screening in infants and young children, but there are significant differences among different inspection findings, even in the reexamination by the same examiner. Therefore, the accuracy of ultrasound imaging in the diagnosis is of insufficient evidence. OBJECTIVE:Through virtual reality three-dimensional reconstruction images showing the structure of acetabulum and femoral head space, to obtain a new parameter in order to enrich measurement standards of Graf ultrasonic diagnosis technology and to further improve the credibility of the diagnosis of developmental dysplasia of the hip. METHODS:Ten fresh cadaver specimens of Chinese infants were selected, including five males and five females. Two-dimensional ultrasonic method was employed for hip screening, and at the same time, multi-slice spiral CT was used for three-dimensional reconstruction fol owed by volume reconstruction and fitting of surface reconstruction to display the anatomic structure around the hip and to simulate Graf’s two-dimensional ultrasound method to measure a andβangles on three-dimensional virtual reality images. RESULTS AND CONCLUSION:As confirmed by three-dimensional reconstruction, Graf’s two-dimensional ultrasound could be used to measure a and angles, truly reflecting the development of bony and cartilaginous acetabulum. Graf’s two-dimensional ultrasound contributed to the proper evaluation of beonatal hip dysplasia, which can be used as a routine examination for developmental dysplasia of the hip. These indicate that to master Graf’s ultrasound technology and strictly grasp the evaluation standards for developmental dysplasia of the hip is the important guarantee for diagnosis of developmental dysplasia of the hip.