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闭孔神经卡压症:新 MRI 参数的评估及其可靠性评估。

Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability.

机构信息

Department of Radiology, Ankara Ataturk Education and Research Hospital, Bilkent, Ankara, Turkey.

出版信息

Skeletal Radiol. 2012 May;41(5):575-87. doi: 10.1007/s00256-011-1257-5. Epub 2011 Aug 29.

Abstract

OBJECTIVE

The aim of this study was to describe the magnetic resonance imaging (MRI) findings in patients with ischiofemoral impingement (IFI) and to evaluate the reliability of these MRI findings.

MATERIALS AND METHODS

Seventy hips of 50 patients with hip pain and quadratus femoris muscle (QFM) edema and 38 hips of 30 control cases were included in the study. The QFM edema and fatty replacement were assessed visually. Ischiofemoral space (IFS), quadratus femoris space (QFS), inclination angle (IA), hamstring tendon area (HTA), and total quadratus femoris muscle volume (TQFMV) measurements were performed independently by two musculoskeletal radiologists. The intra- and interobserver reliabilities were obtained for quantitative variables.

RESULTS

IFS, QFS, and TQFMV values of the patient group were significantly lower than those of controls (P < 0.001). HTA and IA measurements of the patient group were also significantly higher than in controls (P < 0.05). The QFM fatty replacement grades were significantly higher in the patient group than in the control group (P < 0.001). Inter- and intra-observer reliabilities were strong for all continuous variables.

CONCLUSION

Clinicians and radiologists should be aware of IFI in patients with hip or groin pain, and MRI should be obtained for the presence of the QFM edema/fatty replacement, narrowing of the IFS-QFS, and other features that may help in the clinical diagnosis of IFI for the proper diagnosis and treatment of the disease.

摘要

目的

本研究旨在描述坐骨股骨撞击症(IFI)患者的磁共振成像(MRI)表现,并评估这些 MRI 表现的可靠性。

材料与方法

本研究纳入了 50 例髋痛伴 quadratus femoris 肌肉(QFM)水肿和 38 例对照组患者的 70 髋。QFM 水肿和脂肪变性采用目测法评估。坐骨股骨间隙(IFS)、 quadratus femoris 间隙(QFS)、倾斜角(IA)、腘绳肌腱面积(HTA)和 quadratus femoris 总肌肉体积(TQFMV)的测量由 2 名肌肉骨骼放射科医生独立进行。对定量变量进行了内部和观察者间可靠性的评估。

结果

患者组的 IFS、QFS 和 TQFMV 值明显低于对照组(P<0.001)。患者组的 HTA 和 IA 测量值也明显高于对照组(P<0.05)。患者组的 QFM 脂肪变性程度明显高于对照组(P<0.001)。所有连续变量的观察者间和观察者内可靠性均较强。

结论

临床医生和放射科医生应意识到髋关节或腹股沟疼痛患者存在 IFI,对于 QFM 水肿/脂肪变性、IFS-QFS 变窄以及其他可能有助于临床诊断 IFI 的特征,应进行 MRI 检查,以便正确诊断和治疗该疾病。

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