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采用软骨钆延迟增强 MRI 评估髋关节撞击综合征所致的骨关节炎。

Assessment of osteoarthritis in hips with femoroacetabular impingement using delayed gadolinium enhanced MRI of cartilage.

机构信息

Department of Orthopedic Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

出版信息

J Magn Reson Imaging. 2009 Nov;30(5):1110-5. doi: 10.1002/jmri.21830.

Abstract

PURPOSE

To determine the feasibility of assessing early osteoarthritis (OA) in hips with femoroacetabular impingement (FAI) using delayed Gadolinium enhanced MRI of Cartilage (dGEMRIC).

MATERIALS AND METHODS

Thirty-seven hips in 30 patients who had a dGEMRIC scan and radiographic evidence of FAI were identified. Clinical symptoms were assessed. Radiographic measurements were performed to determine acetabular and femoral morphology. The severity of radiographic OA was determined using Tönnis grade and minimum joint space width (JSW). On MRI, the alpha angle was measured on the sagittal oblique slices. Correlations between dGEMRIC index, patient symptoms, morphologic measurements, radiographic OA, and age were determined.

RESULTS

Significant correlations were observed between dGEMRIC index, pain (P < 0.05), and alpha angle (P < 0.05). The correlation of dGEMRIC with alpha angle suggests that hips with more femoral deformity show signs of early OA.

CONCLUSION

The results of osteoplasty for FAI depend on the amount of pre-existing OA in the joint. dGEMRIC may be a useful technique for diagnosis and staging of early osteoarthritis in hips with impingement.

摘要

目的

使用钆延迟增强 MRI 软骨成像(dGEMRIC)评估患有髋关节撞击综合征(FAI)的早期骨关节炎(OA)的可行性。

材料与方法

确定了 30 名患者的 37 个髋关节,这些患者均进行了 dGEMRIC 扫描并具有 FAI 的放射影像学证据。评估了临床症状。进行了放射影像学测量以确定髋臼和股骨形态。使用 Tönnis 分级和最小关节间隙宽度(JSW)确定放射影像学 OA 的严重程度。在 MRI 上,在矢状斜切片上测量 alpha 角。确定了 dGEMRIC 指数、患者症状、形态学测量、放射影像学 OA 和年龄之间的相关性。

结果

dGEMRIC 指数与疼痛(P < 0.05)和 alpha 角(P < 0.05)之间存在显著相关性。dGEMRIC 与 alpha 角的相关性表明,股骨畸形程度越大的髋关节出现早期 OA 的迹象越多。

结论

FAI 骨成形术的效果取决于关节中预先存在的 OA 程度。dGEMRIC 可能是评估撞击性髋关节早期骨关节炎的有用技术。

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