Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Seoul, Korea.
J Ultrasound Med. 2012 Mar;31(3):439-47. doi: 10.7863/jum.2012.31.3.439.
The purpose of this study was to retrospectively evaluate the sonographic findings compared with magnetic resonance (MR) arthrographic and arthroscopic findings in diagnosis of anterosuperior labral tears of the hip.
The Ethics Committees of our institution did not require patient approval or informed consent for this retrospective study. Sixteen symptomatic patients (4 male and 12 female; mean age, 43 years) with sonography, MR arthrography, and arthroscopy were enrolled. At arthroscopy, 11 patients were shown to have anterosuperior labral tears. We evaluated the findings of the anterosuperior acetabular labrum on sonography, with an emphasis on the presence or absence and types of labral tears, and correlated the findings with MR arthrography and arthroscopy. The types of tears were classified into radial flap, radial fibrillated, and longitudinal peripheral (base) tears. We calculated the sensitivity, specificity, and accuracy of sonography and MR arthrography.
On sonography, 12 of 16 patients (75%) had a correct diagnosis of the presence or absence of an anterosuperior labral tear. On MR arthrography, 14 of 16 patients (88%) had a correct diagnosis of the presence or absence of a tear. The sensitivity, specificity, and accuracy for the diagnosis of tears by sonography and MR arthrography were 82%, 60%, and 75% and 91%, 80%, and 88%, respectively.
When the arthroscopic results were used as the reference standard, our preliminary study revealed that sonography managed to show anterosuperior labral abnormalities, although it had a lesser diagnostic ability than MR arthrography in diagnosing anterosuperior labral tears. Additional investigations including larger numbers of patients are required to determine whether sonography can be an alternative or adjunctive imaging technique for diagnosis of hip labral tears, especially in patients who decline or are unable to undergo MR arthrography.
本研究旨在回顾性评估超声与磁共振（MR）关节造影和关节镜检查在诊断髋关节前上盂唇撕裂中的声像图表现。
本回顾性研究经我院伦理委员会批准，无需患者同意。共纳入 16 例有超声、MR 关节造影和关节镜检查的症状性患者（男 4 例，女 12 例；平均年龄，43 岁）。关节镜检查显示 11 例患者存在前上盂唇撕裂。我们重点评估了超声在前上髋臼盂唇上的表现，包括盂唇撕裂的存在与否及类型，并将其与 MR 关节造影和关节镜检查结果进行了相关性分析。撕裂类型分为放射状瓣状、放射状纤维状和纵向基底部撕裂。我们计算了超声和 MR 关节造影的敏感性、特异性和准确性。
在超声上，16 例患者中有 12 例（75%）正确诊断出前上盂唇撕裂的存在或不存在。在 MR 关节造影上，16 例患者中有 14 例（88%）正确诊断出撕裂的存在或不存在。超声和 MR 关节造影诊断撕裂的敏感性、特异性和准确性分别为 82%、60%和 75%和 91%、80%和 88%。
当以关节镜结果为参考标准时，我们的初步研究表明，超声可以显示前上盂唇异常，但在诊断前上盂唇撕裂方面的诊断能力逊于 MR 关节造影。需要进一步研究，包括纳入更多的患者，以确定超声是否可以作为髋关节盂唇撕裂的替代或辅助成像技术，尤其是在那些拒绝或不能进行 MR 关节造影的患者中。
