本文選題：關(guān)節(jié)成形術(shù) + 置換�。� 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：目的 探討全髖關(guān)節(jié)置換術(shù)(total hip arthplasty,THA)后假體周圍骨溶解的影像表現(xiàn),以提高診斷水平。 方法 回顧性分析經(jīng)手術(shù)和病理證實的全髖關(guān)節(jié)置換術(shù)后假體周圍骨溶解的髖關(guān)節(jié)影像資料,總結(jié)其影像特征。24例髖關(guān)節(jié)均行X線平片檢查,其中17例行CT平掃。 結(jié)果 (1)病變部位及類型：假體周圍骨溶解發(fā)生于股骨23例(層型15例,擴張型8例)(95.8%),累及股骨Gruen1～2和6～7區(qū)8例(34.8%),Gruen1、7區(qū)8例(34.8%),Gruen1-7區(qū)6例(26.0%),Gruen2-3.6區(qū)1例(4.3%)；發(fā)生于髖臼21例(層型14例,擴張型7例)(87.5%),累及髖臼Delee Ⅰ～Ⅲ區(qū)14例(66.7%),Delee Ⅰ.Ⅲ區(qū)4例(19.0%),DeleeⅡ～Ⅲ區(qū)2例(9.5%),Delee Ⅰ～Ⅱ區(qū)1例(4.8%)。 (2)病灶表現(xiàn)：病變區(qū)骨皮質(zhì)不規(guī)則變薄24例(100%),灶狀不連續(xù)18例(75.0%),局部消失16例(66.7%),伴小骨碎片10例(41.7%)。鄰近骨皮質(zhì)局限性增厚3例(12.5%),病灶邊緣顯示硬化邊21例(87.5%),杯口狀界面18例(75.0%)。CT平掃的17例中發(fā)現(xiàn)軟組織腫物16例(94.1%)。 (3)假體改變：發(fā)現(xiàn)內(nèi)襯磨損21例(87.5%)；螺釘旁骨質(zhì)缺損11例(45.8%),螺釘穿透髖臼內(nèi)壁3例(12.5%),斷裂2例(8.3%),內(nèi)陷1例(4.2%)；假體周圍金屬碎屑12例(50.0%) (4)并發(fā)癥：股骨假體松動19例(79.2%),髖臼假體松動16例(66.7%)；股骨假體周圍骨折11例(45.8%),髖臼假體周圍骨折5例(20.8%)；股骨假體脫位2例(8.3%) 結(jié)論 全髖關(guān)節(jié)置換術(shù)后假體周圍發(fā)現(xiàn)層型或擴張型骨質(zhì)缺損,伴邊界清晰、密度均勻、有薄包膜的軟組織腫物,結(jié)合髖臼假體磨損改變,能夠?qū)袤w周圍骨溶解作出準(zhǔn)確的影像診斷。
[Abstract]:Purpose To investigate the imaging features of periprosthetic osteolysis after total hip arthroplasty in order to improve the diagnostic level. Method The imaging data of osteolysis around the prosthesis after total hip arthroplasty proved by surgery and pathology were analyzed retrospectively. The imaging features of the hip joints were summarized. All the 24 cases of hip joints were examined by X-ray plain film, of which 17 cases were performed plain CT scan. Result (1) location and type of lesion: osteolysis around the prosthesis occurred in 23 cases of femur (15 cases of lamellar type, 8 cases of dilated type, 8 cases of involvement of Gruen1~2 of femur and 8 cases of Gruen1 ~ (1 / 7) area of the femur, 8 cases of Gruen1-7 region of 34.8N, 6 cases of Gruen2-3.6 region, 1 case of 4.3T), 21 cases of acetabular involvement (14 cases of laminar type, 14 cases of laminar type, 8 cases of Gruen1-7 region), 21 cases of acetabular type (14 cases of laminar type, 14 cases of laminar type). Of the 7 cases of dilated type, 14 cases were involved in acetabular Delee 鈪，

本文編號：1910259