James Steven L J, Ali Kaline, Malara Frank, Young David, O'Donnell John, Connell David A
Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, Brockley Hill, Stanmore, Middlesex, United Kingdom HA7 4LP.
AJR Am J Roentgenol. 2006 Dec;187(6):1412-9. doi: 10.2214/AJR.05.1415.
The purpose of our study was to evaluate MRI in the identification of labral and articular cartilage lesions in patients with a clinical suspicion of femoroacetabular impingement.
Preoperative MRI was performed in 46 consecutive patients (26 men, 20 women; age range, 21-45 years; mean age, 32.3 years) for whom femoroacetabular impingement was clinically suspected. Two musculoskeletal radiologists independently assessed the MR images for the presence and anatomic site of labral disorders, labral-chondral transitional zone disorders, femoral cartilage lesions, and acetabular cartilage lesions. Surgical correlation was obtained in all cases by two surgeons who were experienced in hip arthroscopy.
Seven patients showed labral tears on MRI that were confirmed surgically in all cases. Thirty-seven patients (97%) of the 38 surgically confirmed cases had lesions of the labral-chondral transitional zone on MRI. The sites of labral-chondral transitional zone abnormalities at arthroscopy were 50% anterosuperior, 36% anterosuperior and superolateral, 11% superolateral, and 3% superolateral and posterosuperior. The site was identified correctly in 92% (reviewer 1) and 95% (reviewer 2) of cases on MRI. Separate acetabular cartilage abnormality was surgically identified in 39% of cases, and femoral cartilage lesions were found in 20%. The acetabular chondral lesions were correctly identified in 89-94% of cases.
MRI provides a useful assessment of patients in whom a femoroacetabular impingement is clinically suspected. A high-resolution, nonarthrographic technique can provide preoperative information regarding the presence and anatomic site of labral and cartilage abnormalities.
本研究的目的是评估磁共振成像(MRI)在临床怀疑有股骨髋臼撞击症患者中识别盂唇和关节软骨损伤的能力。
对46例临床怀疑有股骨髋臼撞击症的连续患者(26例男性,20例女性;年龄范围21 - 45岁;平均年龄32.3岁)进行术前MRI检查。两名肌肉骨骼放射科医生独立评估MR图像,以确定盂唇疾病、盂唇 - 软骨过渡区疾病、股骨软骨损伤和髋臼软骨损伤的存在及解剖部位。所有病例均由两名有髋关节镜经验的外科医生进行手术对照。
7例患者MRI显示盂唇撕裂,所有病例均经手术证实。38例手术确诊病例中有37例(97%)在MRI上有盂唇 - 软骨过渡区损伤。关节镜检查时盂唇 - 软骨过渡区异常的部位为:前上50%,前上和上外侧36%,上外侧11%,上外侧和后上3%。MRI上92%(审阅者1)和95%(审阅者2)的病例能正确识别该部位。39%的病例经手术发现单独的髋臼软骨异常情况,20%发现股骨软骨损伤。髋臼软骨损伤在89% - 94%的病例中能被正确识别。
MRI对临床怀疑有股骨髋臼撞击症的患者提供了有用的评估。一种高分辨率、非关节造影技术可提供有关盂唇和软骨异常的存在及解剖部位的术前信息。