摘要
目的通过MRI对发育性髋关节脱位髋周肌肉面积的测量及T2-mapping技术对肌肉T2弛豫时间的定量分析,探讨MRI对发育性髋关节脱位术前髋周肌肉病变的影像诊断价值,并了解T2-mapping在肌肉病变中的应用趋势。方法收集2014年3月至2016年1月经中国医科大学附属盛京医院小儿骨科诊断为单侧发育性髋关节脱位的3岁以下的未经治疗的患儿49例(脱位组)及正常髋关节幼儿8例(正常组),进行MRI常规序列及T2-mapping序列扫描,在MRI冠状面股骨头中心的位置根据Dunn标准将DDH分为3型(Ⅰ型、Ⅱ型、Ⅲ型)。测量髂腰肌、阔筋膜张肌、股直肌、缝匠肌的面积及T2值,并计算面积及T2值患健侧比,分析四块肌肉的面积及T2值的患健侧比值在各组间的差异,并分析各肌肉的面积及T2值的患健侧比与脱位程度的相关性,面积与T2值患健侧比的相关性。结果脱位侧髋周各肌肉的面积及T2值小于健侧;髂腰肌的面积患健侧比在各组间均有明显差异,阔筋膜张肌仅在与DunnⅢ型比较时表现出明显差异,股直肌除正常组与DunnⅠ型、DunnⅠ型与DunnⅡ型无明显差异外,余各组间差异明显,缝匠肌各组间无明显差异;而四块肌肉T2值的患健侧比在各组均表现明显差异。髂腰肌、阔筋膜张肌、股直肌面积的患健侧比与脱位程度呈明显负相关(r值分别为-0.89、-0.56、-0.69,P<0.05),而缝匠肌与脱位程度无明显相关性(P>0.05);四块肌肉T2值的患健侧比均与脱位程度呈明显负相关(r值分别为-0.85、-0.74、-0.80、-0.53,P<0.05);髂腰肌、阔筋膜张肌、股直肌面积与T2值的患健侧比呈明显正相关(r值分别为0.74、0.52、0.64,P<0.05),而缝匠肌面积与T2值的患健侧比不相关。结论幼儿发育性髋脱位髋周肌肉有不同程度的挛缩,在一定程度上会加重髋脱位的发展并影响治疗及预后,T2-mapping技术相较于常规MR能早期发现髋周肌肉内在的改变,对临床早期�
Objective To explore the magnetic resonance imaging (MRI) features of hip muscles for unilateral developmental dysplasia of the hip by measuring the area of hip flexor muscles with MRI and to assess the development tendency of T2-mapping technology in muscle lesions by quantitative analysis of T2 relaxation time. Methods Forty-nine children of unilateral DDH (dislocation group) and eight children of normal hips (control group) aged under 3 years without any treatment were included. All patients underwent routine MRI and T2-mapping sequence. The dislocation group was divided into three types according to Dunn's classification standard. MRI assessment and T2 relaxation time measuring of iliopsoas, rectus femoris, tensor fasia lata and sartorius were performed, muscles of dislocated hip compared with normal contralateral hip and ratios of dislocated and health sides calculated. The difference between different degree of dislocation and the correlation to ratios of area or T2 relaxation time with degree of dislocation, correlation to ratios of area with T2 relaxation time were analyzed. Results Area of hip muscles and T2 relaxation time in dislocated side was less than contralateral side. The area ratios of iliopsoas were significantly different among four groups. Area ratios of tensor fascia lata showed significant difference only in type 3 as compared with other types, ratios of rectus femoris showed in any pairwise comparisons except the comparisons between normal group with type 1 and type 1 with type 2. No significance was detected in sartorius muscle (P=0.115). While T2 relaxation time ratios of four muscles were significantly different among the groups. The area ratios of iliopsoas, tensor fascia lata and rectus femoris were negatively correlated with the dislocation degrees (r values of -0.89,-0.56,-0.69, P<0.05). However, no significance correlation was detected in sartorius muscle. In addition, T2 relaxation time ratios of four muscles were negatively correlated with the degrees of dislocation (r values of
作者
王亚捷
刘玲玲
孟燕
潘诗农
Wang Yajie;Liu Lingling;Meng Yan;Pan Shinong(Department of Radiology, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), Hangzhou 310014, China;Department of Radiology, Affiliated Shengjing Hospital, China Medical University, Shenyang 110004, China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2019年第8期746-751,共6页
Chinese Journal of Pediatric Surgery
关键词
髓脱位
发育性
磁共振成像
弛豫时间
Hip dislocation, developmental
Magnetic resonance imaging
Relaxation time
