Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Clin Orthop Relat Res. 2012 Dec;470(12):3321-31. doi: 10.1007/s11999-012-2403-7.
BACKGROUND: Accurate, reproducible, and noninvasive assessment of hip cartilage is clinically relevant and provides a means by which to assess the suitability of candidates for arthroscopic or open surgical procedures and the response to such interventions over time. Given the relatively thin cartilage of the hip and the complex spherical anatomy, however, accurately assessing the cartilage poses a challenge for traditional MRI techniques. QUESTIONS/PURPOSES: We assessed the current status of imaging articular cartilage of the hip through a comprehensive review of recent literature. METHODS: We performed a literature review using PubMed. Topics included quantitative MRI, imaging of the hip cartilage and labrum, femoroacetabular impingement syndrome, and osteoarthritis of the hip. WHERE ARE WE NOW?: With the use of high in-plane and through-plane resolution, reproducible assessment of hip cartilage and labrum is clinically feasible. More recent quantitative MR techniques also allow for noninvasive assessment of collagen orientation and proteoglycan content in articular cartilage, thus providing insight into early matrix degeneration. These techniques can be applied to cohorts at risk for osteoarthritis, helping to predict cartilage degeneration before symptoms progress and osteoarthritic changes are visible on radiographs. WHERE DO WE NEED TO GO?: Prospective longitudinal data registries are necessary for developing predictive models of osteoarthritis and subsequent joint failure to assess the results of surgical intervention and predict the timing of arthroplasty. HOW DO WE GET THERE?: By establishing more hip cartilage registries, a correlation can be made between subjective measures and morphologic MRI to assess the cartilage, labrum, bone, and synovial lining of the hip.
背景:准确、可重复且无创的髋关节软骨评估与临床相关,可用于评估关节镜或开放式手术候选者的适宜性,以及随着时间的推移对这些干预措施的反应。然而,由于髋关节软骨相对较薄且解剖结构复杂,因此准确评估软骨对传统 MRI 技术提出了挑战。
问题/目的:我们通过对近期文献的综合回顾,评估了髋关节关节软骨成像的现状。
方法:我们使用 PubMed 进行了文献回顾。主题包括定量 MRI、髋关节软骨和盂唇的成像、股骨髋臼撞击综合征和髋关节骨关节炎。
我们现在处于什么位置?:使用高平面内和平面外分辨率,髋关节软骨和盂唇的可重复评估在临床上是可行的。最近的定量磁共振技术还可以非侵入性地评估关节软骨中的胶原方向和蛋白聚糖含量,从而深入了解早期基质退化。这些技术可应用于易患骨关节炎的队列中,有助于在症状进展和放射照相上可见骨关节炎变化之前预测软骨退化。
我们需要去哪里?:需要前瞻性纵向数据登记来开发骨关节炎和随后关节失效的预测模型,以评估手术干预的结果并预测关节置换的时间。
我们如何到达那里?:通过建立更多的髋关节软骨登记处,可以在主观测量和形态 MRI 之间建立相关性,以评估髋关节的软骨、盂唇、骨骼和滑膜衬里。
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