MRI评估发育性髋关节发育不良闭合复位后髋关节发育走向的研究进展

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对目前MRI在发育性髋关节发育不良(developmental dysplasia of the hip,DDH)中各种研究进行综述,重点探讨MRI用于评估DDH闭合复位后髋关节发育走势研究进展,以期为DDH闭合复位后预测髋关节发育走向寻找可靠的指标。由于MRI在识别软骨及软组织上的优势,越来越多的研究在DDH治疗前后进行MRI,评估其在术前、术后的具体作用。进行相应汇总,如利用MRI识别影响脱位髋关节复位的因素,如纤维脂肪组织增生/增厚、关节积液、盂唇内翻、髂腰肌萎缩等;利用MRI观察DDH闭合复位治疗前后股骨头软骨塑形情况;利用MRI验证术中关节造影在评估头臼位置上的有效性以及直接利用MRI观察DDH头臼关系;利用髋关节MR造影评价DDH患者髋臼盂唇损伤情况;此外,亦总结了对MRI评估髋关节相应观测指标进行偏倚校正的研究结果。总的来说,MRI在DDH诊治中的应用日趋成熟与完善,已被很多学者提倡作为DDH常规辅助检查,然而关于DDH闭合复位后如何评估与预测髋关节的发育转归这一热点问题仍无统一定论,从三方面总结了目前的进展:汇总诸多在MRI上测量的结果,代表软骨性髋臼覆盖并用以预测髋臼生长发育的指标;总结关于利用MRI探索盂唇对于髋关节发育影响的研究成果;总结MRI评价闭合复位后股骨头缺血性坏死的相关研究结果。以上内容对于目前的临床工作及研究可提供一定的参考。“,”This article reviews the various studies of MRI in developmental dysplasia of the hip (DDH), focusing on the research progress of MRI in evaluating the developmental trend of hip joint after DDH closed reduction, in order to find reliable indicators for predicting the development of the hip joint after closed reduction of DDH. Due to the advantages of MRI in identifying cartilage and soft tissue, more and more studies have performed MRI before and after DDH treatment to evaluate its specific role. This article has made a corresponding summary, for example, using MRI to identify obstacles that affect the reduction of dislocated hip joints such as fibrofatty tissue hyperplasia/thickening, joint effusion, labrum inversion, iliopsoas muscle atrophy, etc; using MRI to observe the cartilage shaping of the femoral head before and after closed reduction treatment of DDH; using MRI to verify the validity of intraoperative arthrography in assessing the position of femoral head and socket or directly observe the relationship of femoral head and socket with MRI; using hip MR angiography to evaluate the acetabular labrum injury in DDH patients. In addition, the results of bias-corrected studies on MRI-assessed hip-related observations are also summarized. In general, the application of MRI in the diagnosis and treatment of DDH is becoming more and more mature and perfect, and has been advocated by many scholars as a routine auxiliary examination for DDH. However, there is still no consensus on how to evaluate and predict the developmental outcome of the hip joint after closed reduction of DDH. This article summarizes the current progress from three aspects. We summarize the results of many measurements on MRI, which represent cartilage acetabular coverage and are used to predict acetabular growth and development; the research results on the use of MRI to explore the impact of the labrum on the development of the hip joint are summarized; the related research results of MRI evaluation of avascular necrosis of the femoral head after closed reduction are summarized. The above content can provide some reference for the current clinical work and research.
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