Three-dimensional imaging of acetabular dysplasia: diagnostic value and impact on surgical type classification.
OBJECTIVE
To investigate the diagnostic value and the impact on surgical type classification of three-dimensional (3D) images for pre-surgical evaluation of dysplastic hips.


METHODS
Three children with a different surgical type of hip dysplasia were investigated with helical computed tomography. For each patient, two-dimensional (2D) images, 3D, and a stereolithographic model of the dysplastic hip were generated. In two separate sessions, 40 medical observers independently analyzed the 2D images (session 1), the 2D and 3D images (session 2), and tried to identify the corresponding stereolithographic hip model. The influence of both image presentation (2D versus 3D images) and observer (degree of experience, radiologist versus orthopedic surgeon) were statistically analyzed. The SL model choice reflected the impact on surgical type classification.


RESULTS
Image presentation was a significant factor whereas the individual observer was not. Three-dimensional images scored significantly better than 2D images (P=0.0003). Three-dimensional imaging increased the correct surgical type classification by 35%.


CONCLUSIONS
Three-dimensional images significantly improve the pre-surgical diagnostic assessment and surgical type classification of dysplastic hips.
Smet
M H
MH
Department of Radiology, University Hospitals KU-Leuven, Herestraat, 49, 3000, Leuven, Belgium. marleen.smet@uz.kuleven.ac.be
Marchal
G J
GJ
Baert
A L
AL
Van Hoe
L
L
Van Cleynenbreugel
J
J
Daniels
H
H
Molenaers
G
G
Moens
P
P
Fabry
G
G
D000077:Acetabulum / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D015588:Observer Variation; D014057:Tomography, X-Ray Computed