Hospital for Special Surgery, Weil Medical College of Cornell University, New York, NY, USA.
J Magn Reson Imaging. 2010 Feb;31(2):268-78. doi: 10.1002/jmri.22025.
The relatively thin cartilage of the hip joint, as well as its complex geometry, poses challenges for standardized, reproducible assessment of cartilage and the acetabular labrum. With appropriate pulse sequence parameters, however, accurate, reproducible assessment of cartilage and the labrum is feasible. More detailed evaluation of cartilage biochemistry may be obtained with techniques aimed at noninvasively evaluating the integrity of collagen and/or proteoglycan components in the articular cartilage. One of the benefits of noncontrast techniques lie in the ability to visualize the native synovium, and thereby detect the presence of synovial proliferative disorders, the clinical symptoms of which may mimic a labral tear or traumatic cartilage injury. Standard cartilage evaluation allows for the detection of surface delamination and osteoarthritis in the setting of femoroacetabular impingement, as well as subtle areas of subchondral collapse and secondary delamination of cartilage in the setting of osteonecrosis. This preserves the use of hip arthroscopy as a therapeutic rather than a diagnostic tool.
髋关节相对较薄的软骨以及其复杂的几何形状，给标准化、可重复的软骨和髋臼唇评估带来了挑战。然而，通过适当的脉冲序列参数，可以实现软骨和唇的准确、可重复的评估。通过旨在非侵入性评估关节软骨中胶原和/或蛋白聚糖成分完整性的技术，可以更详细地评估软骨生物化学。非对比技术的一个好处在于能够可视化原生滑膜，并因此检测到滑膜增殖性疾病的存在，其临床症状可能类似于唇撕裂或创伤性软骨损伤。标准的软骨评估可在股骨髋臼撞击症的情况下检测到表面分层和骨关节炎，以及在股骨头坏死的情况下检测到细微的软骨下骨塌陷和继发性分层区域。这保留了髋关节镜检查作为治疗而非诊断工具的使用。
