髋关节髋臼唇撕裂和软骨病变:间接 MR 关节造影与关节镜检查的相关性——初步研究。

Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy--a preliminary study.

机构信息

National Musculoskeletal Imaging, 1930 N Commerce Pkwy, Ste. 5, Weston, FL 33326, USA.

出版信息

AJR Am J Roentgenol. 2010 Mar;194(3):709-14. doi: 10.2214/AJR.07.3669.

Abstract

OBJECTIVE

The purpose of this study was to assess the diagnostic correlation between indirect MR arthrography, conventional MRI, and arthroscopy in acetabular labral and cartilage lesions of the hip.

MATERIALS AND METHODS

Fourteen patients who underwent conventional and indirect MR arthrography with arthroscopic correlation were studied over the course of 18 months. MR studies were performed on a 1.5-T magnet. Sequences consisted of unilateral sagittal turbo spin-echo proton density fat-suppressed, axial turbo spin-echo T2 fat-saturated, and coronal turbo spin-echo proton density fat-saturated images. Whole-pelvis coronal T1 and STIR sequences were also performed. Patients received IV gadolinium contrast material and exercised for 15 minutes. Gadolinium-enhanced fat-saturated T1 sequences were obtained in three planes. Arthroscopy was performed by two orthopedic surgeons who specialize in treating hip disorders. Cases were then retrospectively reviewed by two experienced musculoskeletal radiologists who were blinded to the arthroscopic findings. Cases were examined for acetabular labral tears and chondral lesions. Extraarticular findings of femoral acetabular impingement were recorded. Unenhanced and gadolinium-enhanced images of the labrum were compared for differences and changes in diagnosis. Comparison was made between the arthroscopic and MR findings for analysis of the results.

RESULTS

Of the 13 labral tears found at arthroscopy, 85% were detected by conventional MRI, whereas 100% were identified via indirect MR arthrography. Seventy percent of the labral tears identified on conventional MRI were better delineated by indirect MR arthrography. Identification of chondral abnormalities was not improved via indirect MR arthrography over conventional MRI.

CONCLUSION

IV contrast-enhanced indirect MR arthrography appears to be an effective means of hip evaluation for labral tears. It does not appear to improve detection of cartilage abnormalities when compared with conventional MRI.

摘要

目的

本研究旨在评估间接磁共振关节造影术、常规 MRI 与关节镜检查在髋关节髋臼唇和软骨病变中的诊断相关性。

材料与方法

在 18 个月的时间里,我们对 14 名接受常规和间接磁共振关节造影并与关节镜检查相关联的患者进行了研究。磁共振研究在 1.5T 磁体上进行。序列包括单侧矢状面涡轮自旋回波质子密度脂肪抑制、轴向涡轮自旋回波 T2 脂肪饱和和冠状面涡轮自旋回波质子密度脂肪抑制图像。还进行了全骨盆冠状面 T1 和短 TI 反转恢复(STIR)序列。患者接受 IV 钆造影剂并运动 15 分钟。在三个平面上获得增强脂肪饱和 T1 序列。由两位专门治疗髋关节疾病的骨科医生进行关节镜检查。然后由两位具有丰富经验的肌肉骨骼放射科医生对两位医生进行回顾性检查,他们对关节镜检查结果并不知情。对髋臼唇撕裂和软骨病变进行了检查。记录了股骨髋臼撞击症的关节外发现。比较了未增强和增强的髋臼唇图像,以观察诊断的差异和变化。对关节镜和磁共振检查结果进行比较,分析结果。

结果

在关节镜下发现的 13 个髋臼唇撕裂中,85%可通过常规 MRI 检测到,而 100%可通过间接磁共振关节造影术检测到。常规 MRI 检测到的 70%髋臼唇撕裂在间接磁共振关节造影术下得到更好的描绘。间接磁共振关节造影术在检测软骨异常方面并未优于常规 MRI。

结论

静脉内对比增强的间接磁共振关节造影术似乎是一种评估髋关节唇撕裂的有效方法。与常规 MRI 相比,它似乎并不能提高对软骨异常的检测。

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