Hinsdale Orthopaedics Associates, Hinsdale, Illinois, USA.
Arthroscopy. 2012 May;28(5):619-27. doi: 10.1016/j.arthro.2011.10.021. Epub 2012 Feb 1.
The purpose of this study was to evaluate the correlation between computed tomography (CT) and magnetic resonance imaging (MRI) measurements of femoral anteversion, as well as the relation of anteversion with physical examination and radiographic findings.
Preoperative CT and MRI measurements of anteversion along with clinical examination were performed on 129 consecutive hips before hip arthroscopy for nonarthritic hip injuries. All anteversion measurements were performed by 2 musculoskeletal radiologists. The radiographic findings and physical examination findings were analyzed for statistically significant correlations. For statistical analysis purposes, the patients were divided into 3 groups according to the mean CT anteversion measurement: group I (low), less than 10°; group II (medium), 10° to 22°; and group III (high), greater than 22°.
High interobserver correlation was found for femoral anteversion measurement by CT and MRI (r = 0.95 and r = 0.86, respectively; P < .0001 for both). CT and MRI measurements showed high correlation with each other (r = 0.80, P < .0001). However, in 96% of the cases, the CT measurement was larger, with a mean difference of 8.9° (range, -37° to 1.5°). A significant correlation coefficient was found between internal rotation and anteversion angles as measured by CT (r = 0.36, P < .0001). However, no correlation was found with other hip movement measurements. Abnormal femoral acetabular bony architecture of the hip was found in 64% of the patients; isolated cam impingement was more prevalent in group I, whereas isolated pincer impingement was more prevalent in group III (P = .01).
Although high correlation was found between anteversion angle measurements by CT and MRI, significant discrepancies in the absolute anteversion number between the 2 techniques suggest that they may not be interchangeable. Furthermore, CT was found to have higher interobserver reliability than MRI. There was a significant correlation between CT and examination of internal rotation of the hip. Clinically, the findings of the study show that the diagnosis of excessive femoral anteversion or retroversion should have different thresholds according to MRI and CT measurements; moreover, the diagnosis should not rely exclusively on either examination or radiologic criteria.
Level III, retrospective comparative study.
本研究旨在评估股骨前倾角的计算机断层扫描（CT）和磁共振成像（MRI）测量之间的相关性，以及前倾角与体格检查和影像学发现的关系。
对 129 例非关节炎性髋关节损伤行髋关节镜术前的 CT 和 MRI 测量以及临床检查，对股骨前倾角进行前瞻性研究。所有前倾角测量均由 2 名肌肉骨骼放射科医生进行。对影像学和体格检查结果进行统计学分析。为了进行统计学分析，根据 CT 前倾角测量的平均值将患者分为 3 组：I 组（低），小于 10°；II 组（中），10°至 22°；III 组（高），大于 22°。
CT 和 MRI 测量的股骨前倾角具有高度的观察者间相关性（r = 0.95 和 r = 0.86；均 P <.0001）。CT 和 MRI 测量之间也具有高度相关性（r = 0.80，P <.0001）。然而，在 96%的情况下，CT 测量值更大，平均差值为 8.9°（范围：-37°至 1.5°）。CT 测量的内旋和前倾角之间存在显著的相关系数（r = 0.36，P <.0001）。然而，与其他髋关节运动测量无相关性。64%的患者存在髋关节髋臼骨结构异常；孤立的凸轮撞击在 I 组更为常见，而孤立的钳夹撞击在 III 组更为常见（P =.01）。
尽管 CT 和 MRI 测量的前倾角之间存在高度相关性，但两种技术之间绝对前倾角数值存在显著差异，提示它们可能不能互换。此外，CT 的观察者间可靠性高于 MRI。CT 与髋关节内旋检查之间存在显著相关性。临床研究结果表明，对股骨前倾角或后倾角的诊断应根据 MRI 和 CT 测量值设定不同的阈值；此外，诊断不应仅依赖于体格检查或影像学标准。
III 级，回顾性比较研究。
