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Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.

Abstract：

:Purpose To validate accuracy of diagnosis of developmental dysplasia of the hip (DDH) from geometric properties of acetabular shape extracted from three-dimensional (3D) ultrasonography (US). Materials and Methods In this retrospective multi-institutional study, 3D US was added to conventional two-dimensional (2D) US of 1728 infants (mean age, 67 days; age range, 3-238 days) evaluated for DDH from January 2013 to December 2016. Clinical diagnosis after more than 6 months follow-up was normal (n = 1347), borderline (Graf IIa, later normalizing spontaneously; n = 140) or dysplastic (Graf IIb or higher, n = 241). Custom software accessible through the institution's research portal automatically calculated indexes including 3D posterior and anterior alpha angle and osculating circle radius from hip surface models generated with less than 1 minute of user input. Logistic regression predicted clinical diagnosis (normal = 0, dysplastic = 1) from 3D indexes (ie, age and sex). Output represented probability of hip dysplasia from 0 to 1 (output: >0.9, dysplastic; 0.11-0.89, borderline; <0.1, normal). Software can be accessed through the research portal. Results Area under the receiver operating characteristic curve was equivalently high for 3D US indexes and 2D US alpha angle (0.996 vs 0.987). Three-dimensional US helped to correctly categorize 97.5% (235 of 241) dysplastic and 99.4% (1339 of 1347) normal hips. No dysplastic hips were categorized as normal. Correct diagnosis was provided at initial 3D US scan in 69.3% (97 of 140) of the studies diagnosed as borderline at initial 2D US scans. Conclusion Automatically calculated 3D indexes of acetabular shape performed equivalently to high-quality 2D US scans at tertiary medical centers to help diagnose DDH. Three-dimensional US reduced the number of borderline studies requiring follow-up imaging by over two-thirds.

journal_name

Radiology

journal_title

Radiology

authors

Zonoobi D,Hareendranathan A,Mostofi E,Mabee M,Pasha S,Cobzas D,Rao P,Dulai SK,Kapur J,Jaremko JL

doi

10.1148/radiol.2018172592

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

1003-1015

issue

eissn

0033-8419

issn

1527-1315

journal_volume

287

pub_type

杂志文章,多中心研究

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Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.