摘要目的 运用CT三维重建(three-dimensional reconstructed computed tomography,3DCT)技术对引产儿髂骨进行扫描,观察不同层面中髂骨形态的变化并测量髋臼髂骨倾角,为婴幼儿髋关节的超声检查提供参考.方法 引产儿1例,运用3DCT重建技术从不同切面对引产儿的骨盆进行扫描,观察不同层面中髂骨的形态并测量髋臼髂骨倾斜角.结果 获取单侧髂骨矢状面25个不同层面中髂骨翼外板的形态特征.在单侧髂骨横断面1650个层面中,有3个层面可见髂骨翼外板平直并与矢状面平行,且均位于耻骨与坐骨之间,这3个层面的髋臼倾斜角度(acetabular inclined angle,AIA)分别为30.9°、29.7°和30.4°;有33个层面图像穿过髂骨下缘,这些层面的髂骨翼外板可见形态变化,髋臼倾斜角度分别为:32.3°、28.8°、28.3°、29.6°、30.6°、31.2°和32.3°;在耻骨与坐骨之间,平行于参考层面的各层面图像中髂骨翼外板可见形态变化,髋臼倾斜角度分别为:26.8°、29.1°、29.5°、32.3°和33.5°.以髂骨外板直线为轴的6张扇形扫描图像中髋臼倾斜角度分别为:32.9°、30.7°,29.7°,29.4°、30.4°和30.6°.结论 在婴幼儿髂骨不同位置和层面的扫描图像上,髂骨翼形态及髋臼髂骨倾斜角均有变化.婴幼儿髋关节超声检查必须按照切面顺序逐一操作,同一切面的诊断标准不适合于其他切面.

abstractsObjective To explore the morphology of iliac wing in different pelvic sections and measure acetabular inclined angles by the technique of three-dimensional reconstructed computed tomography(3DCT)so as to provide rationales for neonatal hip sonography.Methods An aborted fetal pelvis was scanned in sagittal,perpedicularing-to-sagittal and perpedicularing-to-horizontal planes by 3DCT.The morphology of iliac wing was observed in different sections and acetabular inclined angles were measured.Results The morphology of iliac wing were inconsistent in 25 sagittal planes.From medial to lateral,they were rough,gradually flattened,slightly turned inward and then reflattened.Scanning pelvis in perpendicular-to-sagittal plane at different angles,3/1650 sections had iliac wings straight and parallel to sagittal plane.Between pubis and ischium,their acetabular inclined angles were 30.9°,29.7°and 30.4°respectively;33/1650 sections passed lower limb,from front to back,their iliac wings were from outward tilt to gradually inward tilt,their acetabular inclined angles were 32.3°,28.8°,28.3°,29.6°,30.6°,31.2°and 32.3°respectively;between pubis and ischium,in some parallel standard sections from front to back,their iliac wings were from outward tilt to gradually inward tilt and their acetabular inclined angles were 26.8°,29.1°,29.5°,32.3°and 33.5° respectively.Paralleling the straight iliac wing and scanning pelvis at different angles,550 sections were obtained.And 11 sections passed the straight iliac wing of middle section from front to back.Their acetabular inclined angles were 32.9°,30.7°,29.7°,29.4°,30.4° and 30.6° respectively.Conclusions The morphology of iliac wing and acetabular inclined angles vary in different sections.Hip sonography must be examined in a strict order and measured in the same section.The diagnostic criteria of one section are inappropriate for other sections.