Brossmann J, Plötz G M, Steffens J C, Hassenpflug J, Heller M
Klinik für Diagnostische Radiologie, Christian-Albrechts-Universität Kiel.
Rofo. 1999 Aug;171(2):143-8. doi: 10.1055/s-1999-241.
To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities.
Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 T MR scanner (Vision, Siemens; FOV 16 cm, matrix 256 x 256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically.
In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively.
MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis.
研究老年髋关节髋臼盂唇损伤的发生率，并确定磁共振关节造影（MRa）检测这些异常的敏感性和特异性。
对20个尸体髋关节进行MRa检查。进行MRa时，在透视引导下注入15 ml碘化造影剂溶液（Solutrast 300）和钆喷酸葡胺（Gd-DTPA）的混合溶液（100:1）。在1.5 T磁共振扫描仪（Vision，西门子；视野16 cm，矩阵256×256，脂肪抑制三维快速扰相梯度回波序列）上进行磁共振成像。在斜冠状面、斜轴面和径向平面上垂直于髋臼进行多平面图像重建。对盂唇标本进行宏观检查。
在20个髋关节中的12个（60%），病理检查发现盂唇损伤。在7个标本中，盂唇在负重的上区域部分或完全分离。发现1个盂唇的瓣状变异；在4个髋关节中，盂唇发生退变（1例囊性退变）。MRa在12个标本中的8个（敏感性67%）证实了病理结果。所有退变的盂唇在MRa上均被正确诊断。3个小的盂唇分离和瓣状变异被误诊为正常。无假阳性结果（特异性100%）。准确性为80%。分别在6/8和6/12的有和无骨关节炎的髋关节中发现盂唇损伤。
MRa非常适合描绘髋臼盂唇并诊断盂唇异常。检测小的盂唇分离和解剖变异困难，需要一定经验。盂唇损伤与髋关节骨关节炎相关，但在无潜在骨关节炎的老年人中也可能常见。
