Yamamoto Yasuhiro, Tonotsuka Hisahiro, Ueda Tatsuya, Hamada Yoshiki
University of Yamanashi, Yamanashi, Japan.
Arthroscopy. 2007 Dec;23(12):1290-4. doi: 10.1016/j.arthro.2007.07.005.
The purpose of this study was to evaluate the usefulness of radial contrast-enhanced computed tomography (CT) in the diagnosis of acetabular labrum injury.
We studied 21 hip joints in 21 patients (8 joints in 8 male patients and 13 joints in 13 female patients), aged between 16 and 81 years (mean, 43 years) at examination, who underwent both radial contrast-enhanced CT and hip arthroscopy. Plain radiography showed no abnormalities in the bone and joint in 19 joints and acetabular dysplasia in 2 joints. When we performed radial contrast-enhanced CT, a mixture of 5 mL of 2% lidocaine chloride and 10 mL of 64% iotrolan was injected intra-articularly under x-ray fluoroscopy. CT was conducted with a 4-slice multidetector CT system operated at a voltage of 120 kilovolt peak, current of 300 mA, collimation beam of 2 mm, field of view of 320 mm, slice thickness of 0.5 mm, table speed of 44 mm/s, and helical pitch of 5.5. Images were reconstructed by computer software for radial slices at 15 degrees intervals perpendicular to the labral rim. The mean interval between the CT scan and arthroscopy was 13.2 days.
By contrast-enhanced CT, acetabular labrum tears were observed in 12 joints, loss of acetabular labrum was found in 1 joint, and no abnormalities were present in 8 joints. By arthroscopy, acetabular labrum tears were observed in 13 joints, loss of acetabular labrum was found in 1 joint, and no abnormalities were present in 7 joints. When the results of the 2 methods were compared, 12 joints had true-positive findings, 8 joints had true-negative findings, and 1 joint had a false-negative finding. Therefore contrast-enhanced CT had a sensitivity of 92.3%, specificity of 100%, and accuracy of 95.2%.
The sensitivity, specificity, and accuracy of radial contrast-enhanced CT for the diagnosis of acetabular labrum injury are 92.3%, 100%, and 95.2%, respectively. We recommend radial contrast-enhanced CT for the diagnosis of acetabular labrum injury in patients in whom magnetic resonance imaging is contraindicated.
Level IV, diagnostic study.
本研究旨在评估经桡动脉增强计算机断层扫描（CT）在髋臼盂唇损伤诊断中的应用价值。
我们对21例患者的21个髋关节进行了研究（8例男性患者的8个关节和13例女性患者的13个关节），检查时年龄在16至81岁之间（平均43岁），这些患者均接受了经桡动脉增强CT和髋关节镜检查。X线平片显示，19个关节的骨骼和关节无异常，2个关节存在髋臼发育不良。在进行经桡动脉增强CT时，在X线透视下向关节腔内注射5 mL 2%的盐酸利多卡因和10 mL 64%的碘海醇混合液。使用4层螺旋CT系统进行CT检查，管电压为120千伏峰值，电流为300毫安，准直束为2毫米，视野为320毫米，层厚为0.5毫米，床速为44毫米/秒，螺距为5.5。通过计算机软件重建垂直于盂唇边缘以15度间隔的桡侧切片图像。CT扫描与关节镜检查之间的平均间隔时间为13.2天。
经增强CT检查，12个关节观察到髋臼盂唇撕裂，1个关节发现髋臼盂唇缺失，8个关节未发现异常。经关节镜检查，13个关节观察到髋臼盂唇撕裂，1个关节发现髋臼盂唇缺失，7个关节未发现异常。比较两种方法的结果时，12个关节为真阳性结果，8个关节为真阴性结果，1个关节为假阴性结果。因此，增强CT的敏感性为92.3%，特异性为100%，准确性为95.2%。
经桡动脉增强CT诊断髋臼盂唇损伤的敏感性、特异性和准确性分别为92.3%、100%和95.2%。对于磁共振成像禁忌的患者，我们建议使用经桡动脉增强CT诊断髋臼盂唇损伤。
IV级，诊断性研究。
