【摘要】：[目的]研究晚期髖關(guān)節(jié)結(jié)核髖臼骨破壞三維特點。[方法]2010年11月~2016年12月確診的晚期髖關(guān)節(jié)結(jié)核病患者73例,男性39例,女性34例,平均年齡(47.95±16.61)(19~85)歲。所有患者采用320排CT行骨盆容積掃描,將DICOM格式數(shù)據(jù)應(yīng)用Mimics軟件行骨盆三維重建。應(yīng)用鏡像技術(shù)還原變病髖臼破壞前三維結(jié)構(gòu),將正常髖臼設(shè)定為標(biāo)準(zhǔn)半球,應(yīng)用球面擬合技術(shù)確定髖臼中心,根據(jù)標(biāo)記點將病變髖臼分為上區(qū)、前區(qū)、下區(qū)和后區(qū)。計算出正常髖臼容積、髖臼骨破壞總?cè)莘e及各分區(qū)骨破壞容積。將髖臼骨破壞容積值及各區(qū)破壞容積值換算成占正常髖臼容積百分比。根據(jù)骨破壞容積占髖臼容積百分比將髖臼骨破壞程度劃分為3度,輕度:50%;中度:50%~100%;重度:100%。根據(jù)單一區(qū)骨破壞占總破壞容積百分比將髖臼骨破壞分為2型,彌漫型:50%;節(jié)段型:≥50%。[結(jié)果]73例患者髖臼破壞容積占髖臼容積比例平均為(0.62±0.48)(0.06~1.68);髖臼破壞程度:輕度破壞36例(50%),中度破壞25例(36%),重度破壞12例(14%);髖臼骨破壞分型:彌漫型骨破壞56例(77%),節(jié)段型骨破壞17例(23%);上區(qū)骨破壞容積大于前區(qū)、后區(qū)骨破壞容積(P0.05),前區(qū)、后區(qū)骨破壞容積大于下區(qū)骨破壞容積(P0.05),前區(qū)骨破壞容積與后區(qū)比較差異無統(tǒng)計學(xué)意義(P0.05)。[結(jié)論]采用320排CT行骨盆容積掃描,數(shù)據(jù)用Mimics軟件三維重建,髖臼骨破壞進行分區(qū)容積計算,確定晚期髖關(guān)節(jié)結(jié)核髖臼骨破壞形態(tài)、方位、程度及類型,可全面反映晚期髖關(guān)節(jié)結(jié)核髖臼骨破壞的三維特點,有助于治療計劃的制定。
[Abstract]:[objective] to study the three-dimensional characteristics of acetabular bone destruction in advanced hip tuberculosis. [methods] from November 2010 to December 2016, 73 patients with advanced tuberculosis of hip joint were diagnosed, 39 males and 34 females, with an average age of (47.95 鹵16.61) (1985) years. All patients were performed pelvic volume scan with 320 rows of CT and 3 D pelvic reconstruction with Mimics software. Three dimensional structure of acetabular lesion was reduced by mirror image technique. The normal acetabular was set as standard hemispheres. The acetabular center was determined by spherical fitting technique. The acetabular lesion was divided into upper, anterior, inferior and posterior areas according to the labeled points. The normal acetabular volume, the total acetabular destruction volume and the bone destruction volume were calculated. The destruction volume of acetabular bone was converted to the percentage of normal acetabular volume. According to the percentage of bone destruction volume to acetabular volume, the degree of acetabular destruction was divided into 3 degrees, mild: 50; moderate: 50 ~ 100; severe: 100. Acetabular bone destruction was divided into 2 types according to the percentage of single area bone destruction to the total destroyed volume, diffuse type: 50 knuckle, segmental type: 鈮，

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