Jaramillo D, Galen T A, Winalski C S, DiCanzio J, Zurakowski D, Mulkern R V, McDougall P A, Villegas-Medina O L, Jolesz F A, Kasser J R
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.
Radiology. 1999 Aug;212(2):519-25. doi: 10.1148/radiology.212.2.r99au39519.
To evaluate the use of magnetic resonance (MR) imaging during manual positioning of the hip, or multipositional MR imaging, in an open-magnet configuration to study femoral head containment, articular congruency, and femoral head deformity in Legg-Calvé-Perthes disease.
In 12 children with advanced Legg-Calvé-Perthes disease, multipositional MR imaging and conventional arthrography were compared in the assessment of containment, femoroacetabular congruency, and femoral head deformity. Images of the hips in several positions were compared subjectively and objectively.
MR imging correlated well with arthrography for overall subjective assessment of severity of disease (r = 0.71, P = .01), with good interobserver agreement (kappa = 0.65, P < .001). MR images demonstrated all cases of hinge abduction shown arthrographically. However, MR imaging failed to depict one case of femoral head flattening. MR imaging correlated well with arthrography in the objective evaluation of joint fluid and lateral subluxation (r = 0.80, P < .01). MR imaging correlated poorly with arthrography in the measurement of sphericity of the femoral head.
Multipositional MR imaging with an open-magnet configuration was comparable to arthrography for demonstration of femoral head containment and congruency of the articular surfaces of the hip. In the evaluation of deformity, it performed less well.
评估在开放式磁体配置下，于髋关节手动定位过程中使用磁共振（MR）成像，即多体位MR成像，以研究Legg-Calvé-Perthes病中的股骨头包容情况、关节一致性和股骨头畸形。
对12例晚期Legg-Calvé-Perthes病患儿，比较多体位MR成像和传统关节造影在评估包容情况、股骨髋臼一致性和股骨头畸形方面的效果。对髋关节在多个位置的图像进行主观和客观比较。
在对疾病严重程度的总体主观评估中，MR成像与关节造影相关性良好（r = 0.71，P = 0.01），观察者间一致性良好（kappa = 0.65，P < 0.001）。MR图像显示了关节造影所示的所有铰链外展病例。然而，MR成像未能显示一例股骨头扁平情况。在对关节积液和外侧半脱位的客观评估中，MR成像与关节造影相关性良好（r = 0.80，P < 0.01）。在测量股骨头球形度方面，MR成像与关节造影相关性较差。
开放式磁体配置的多体位MR成像在显示股骨头包容情况和髋关节关节面一致性方面与关节造影相当。在评估畸形方面，其表现欠佳。
