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 t ype classification of three-dimensional (3D) images for pre-surgical evalua tion of dysplastic hips, Materials and methods: Three children with a diffe rent surgical type of hip dysplasia were investigated with helical computed tomography. For each patient, two-dimensional (2D images, 3D, and a stereo lithographic model of the dysplastic hip were generated. In two separate se ssions, 40 medical observers independently analyzed the 2D images (session 1), the 2D and 3D images (session 2), and tried to identify the correspondi ng stereolithographic hip model. The influence of both image presentation ( 3D versus 3D images) and observer (degree of experience, radiologist versus orthopedic surgeon) were statistically analyzed. The SL model choice refle cted the impact on surgical type classification. Results: Image presentatio n was a significant factor whereas the individual observer was nor. Three-d imensional images scored significantly better than 2D images (P = 0.0003). Three-dimensional imaging increased the correct surgical type classificatio n by 35%. Conclusion: Three-dimensional images significantly improve the pr e-surgical diagnostic assessment and surgical type classification of dyspla stic hips. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.