Department of Radiology, New York University Hospital for Joint Diseases, New York University Langone Medical Center, 660 First Ave, Rm 218, New York, NY 10016, USA.
AJR Am J Roentgenol. 2012 Oct;199(4):879-83. doi: 10.2214/AJR.11.8193.
The objective of our study was to investigate the association between high fovea capitis (fovea alta) and hip dysplasia in young adults.
In a retrospective study, blinded observers reviewed 82 pelvic radiographic and hip MRI studies of three groups of patients: those with developmental dysplasia of the hip (DDH) (center-edge angle, ≤20°), those with borderline DDH (center-edge angle, 21°-25°), and control patients (center-edge angle, >25°). The center-edge angle and coxa valga (femoral neck-shaft angle, >135°) were assessed on pelvic radiographs, and fovea alta was assessed on MR images (delta angle, ≤10°). The Mann-Whitney and Fisher exact tests were used to correlate fovea alta with DDH and with coxa valga, respectively. Interobserver agreement for center-edge and delta angles and the diagnostic performance of fovea alta as a marker of DDH were calculated.
Thirty-one patients with DDH, 23 with borderline DDH, and 28 without DDH were included. Excellent interobserver agreement was found for center-edge angle (concordance correlation coefficient, 0.94) and for delta angle (concordance correlation coefficient, 0.91). Fovea alta had a significant association with DDH (p<0.001) but no association with coxa valga (p>0.57). A significant difference (p<0.001) was found between patients with DDH (3.4°) and those without DDH (21.7°) with respect to mean delta angle measurements. Fovea alta had 69.4% sensitivity, 82.1% specificity, 67.2% positive predictive value, 81.0% negative predictive value, and 75.6% overall accuracy as an indicator of DDH.
Fovea alta shows promise as a strong MRI marker of DDH.
本研究的目的是探讨高股骨头（高股骨头）与年轻成年人髋关节发育不良之间的关系。
在一项回顾性研究中，观察者对三组患者的 82 例骨盆 X 线和髋关节 MRI 研究进行了盲法评估：一组为发育性髋关节发育不良（DDH）（中心边缘角，≤20°），一组为边界 DDH（中心边缘角，21°-25°），一组为对照组（中心边缘角，>25°）。骨盆 X 线片评估中心边缘角和髋外翻（股骨颈干角，>135°），MR 图像评估高股骨头（delta 角，≤10°）。采用 Mann-Whitney 和 Fisher 确切检验分别将高股骨头与 DDH 和髋外翻相关联。计算中心边缘角和 delta 角的观察者间一致性以及高股骨头作为 DDH 标志物的诊断性能。
共纳入 31 例 DDH 患者、23 例边界 DDH 患者和 28 例无 DDH 患者。中心边缘角（一致性相关系数，0.94）和 delta 角（一致性相关系数，0.91）的观察者间一致性非常好。高股骨头与 DDH 有显著相关性（p<0.001），但与髋外翻无相关性（p>0.57）。DDH 患者（3.4°）与无 DDH 患者（21.7°）的平均 delta 角测量值差异有统计学意义（p<0.001）。高股骨头作为 DDH 的指标具有 69.4%的敏感性、82.1%的特异性、67.2%的阳性预测值、81.0%的阴性预测值和 75.6%的总准确性。
高股骨头是 DDH 的一种强有力的 MRI 标志物。
