Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, Zurich 8008, Switzerland.
Radiology. 2010 Dec;257(3):754-63. doi: 10.1148/radiol.10092183. Epub 2010 Sep 27.
To assess the association between trochanteric surface irregularities seen on conventional radiographs and magnetic resonance (MR) evidence of abductor tendon abnormalities.
A total of 150 consecutive patients were evaluated in this retrospective study (age range, 21-88 years; mean age, 58.7 years ± 16.1 [standard deviation]; 57 men, 93 women). Because patients' rights are protected by a procedure in which they are asked to provide general approval for their records and images to be reviewed for scientific purposes, specific approval by the institutional review board was not required. Two readers independently analyzed conventional radiographs and MR images of the hip. Trochanteric surface was graded on conventional radiographs as normal, osseous irregularities extending 1-2 mm, or osseous irregularities extending more than 2 mm. On MR images, the gluteus minimus and gluteus medius tendons were classified as normal or as having tendinopathy or a partial- or full-thickness tear. Logistic regression analysis and the Fisher exact test were used for statistical analysis. Sensitivity, specificity, accuracy, positive and negative predictive values, and positive likelihood ratio were calculated. To assess interobserver agreement, a κ statistic was used.
The positive predictive value of surface irregularities larger than 2 mm for MR tendinopathy or a partial- or full-thickness tear was 90% (37 of 41 patients). The sensitivity of radiographic changes was 40%; the specificity, 94%; the accuracy, 61%; the negative predictive value, 49%; and the positive likelihood ratio, 5.8. Interobserver agreement for detection of trochanteric surface irregularities on conventional radiographs ranged from 0.28 to 0.76.
Pronounced (>2 mm) surface irregularities of the greater trochanter on conventional radiographs were associated with abductor tendon MR abnormalities.
评估常规 X 线片上所见的转子部表面不规则与外展肌腱异常的磁共振（MR）证据之间的相关性。
在这项回顾性研究中，共评估了 150 例连续患者（年龄范围：21-88 岁；平均年龄：58.7 岁±16.1[标准差]；57 名男性，93 名女性）。由于患者的权利受到保护，他们被要求提供一般同意，以便审查其记录和图像以用于科学目的，因此不需要机构审查委员会的具体批准。两位读者独立分析了髋关节的常规 X 线片和 MR 图像。转子部表面在常规 X 线上分级为正常、骨不规则延伸 1-2mm 或骨不规则延伸超过 2mm。在 MR 图像上，臀小肌和臀中肌肌腱被分类为正常或存在肌腱病或部分或全层撕裂。使用逻辑回归分析和 Fisher 确切检验进行统计学分析。计算敏感性、特异性、准确性、阳性和阴性预测值以及阳性似然比。为了评估观察者间的一致性，使用了κ统计量。
表面不规则大于 2mm 对 MR 肌腱病或部分或全层撕裂的阳性预测值为 90%（41 例患者中的 37 例）。放射变化的敏感性为 40%；特异性，94%；准确性，61%；阴性预测值，49%；阳性似然比，5.8。在常规 X 线片上检测转子部表面不规则的观察者间一致性范围为 0.28-0.76。
在常规 X 线片上，明显的（>2mm）转子部表面不规则与外展肌腱的 MR 异常相关。
