摘要目的 探索三维高频超声髋关节检查技术在诊断新生儿发育性髋关节异常(DDH)中的应用价值.方法 2010年6月至2010年12月,采用PHILIPS IU22超声诊断仪,二维加三维高频线阵探头,对768例新生儿行髋关节超声筛查.新生儿7d内行超声波髋关节筛查,采用Graf法及股骨头覆盖率比值测量髋关节,并结合三维成像图评判髋关节发育情况.结果 本组受检新生儿768例(1 536髋),其中女婴398例,男婴370例,新生儿平均受检时间为出生后5.8d.正常的髋关节共1 412髋,占91.92％；髋关节不稳定共99髋,占6.45％；髋关节发育不良19髋、半脱位4髋、脱位2髋,共占1.63％.结论 Graf的髋关节额状面成像技术,可以对新生儿髋关节进行清晰的超声成像,并进行了定性、定量分析,诊断DDH,但标准图像的获得是测量和诊断的关键,它会受操作者的技术影响.三维超声成像技术,可观察髋关节空间结构,旋转X、Y、Z轴,更可从不同角度观察髋关节的发育情况,提供髋关节解剖形态和关节功能的信息,并能早期显示髋关节解剖结构,这点是传统X线片不能比拟的优势,图像更加直观,加上高频超声波检查的无放射性损害,重复性强,因此二维和三维超声二者相结合诊断发育性髋关节异常,更符合临床上治疗髋臼发育不良的时间越早越好的需求.

abstractsObjective To explore the value of three-dimensional (3D) sonography in the evaluation of developmental dysplasia of the hip (DDH).Methods From June 2010 to December 2010,768newborns were screened by two-dimensional combined with 3D high-fiequency linear array detector.And newborns younger than 7 days are screened by the method of Graf and the femoral coverage ratio measurement,combined with the hip 3D image,to judge the hip development.Results Out of 768 newborn (398 females and 370 males,average 5.8 days),there were 1 412 normal hip(91.92％),99 hip unstable (6.45％),19 hip dysplasia,4 hip subluxation and 2 hip dislocation (1.63％).Conclusions Graf hip frontal sagittal plane imaging is useful for the diagnosis of DDH.Three-dimensional ultrasound imaging can observe the hip structure and the development of the hip,2D combines with 3D ultrasound are more suitable for the earlier diagnosis of DDH.