Lepage-Saucier Marianne, Thiéry Cécile, Larbi Ahmed, Lecouvet Frédéric E, Vande Berg Bruno C, Omoumi Patrick
Cliniques Universitaires Saint Luc - Université Catholique de Louvain, Woluwe-Saint-Lambert, Belgium,
Eur Radiol. 2014 Jul;24(7):1707-14. doi: 10.1007/s00330-014-3171-4. Epub 2014 Apr 27.
To determine the means and the reference intervals of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in normal hips with high-resolution computed tomography (CT).
We prospectively included 94 adult individuals who underwent CT for thoracic, abdominal or urologic pathologies. Patients with a clinical history of hip pathology and/or with osteoarthritis on CT were excluded. We calculated means and 95% reference intervals for imaging signs of cam-type (alpha angle at 90° and 45° and femoral head-neck offset) and pincer-type impingement (acetabular version angle, lateral centre-edge angle and acetabular index).
The 95 % reference interval limits were all far beyond the abnormal thresholds found in the literature for cam-type and to a lesser extent for pincer-type FAI. The upper limits of the reference intervals for the alpha angles (at 90°/45°) were 68°/83° (men) and 69°/84° (women), compared to thresholds from the literature (50°, 55° or 60°). Reference intervals were similar between genders for cam-type parameters, and slightly differed for pincer-type.
The 95% reference intervals of morphometric measurements of FAI in asymptomatic hips were beyond the abnormal thresholds, which was especially true for cam-type FAI. Our results suggest the need for redefining the current morphometric parameters used in the diagnosis of FAI.
• 95% reference intervals limits of FAI morphotype were beyond currently defined thresholds. • Reference intervals of pincer-type morphotype measurements were close to current definitions. • Reference intervals of cam-type morphotype measurements were far beyond the current definitions. • Current morphometric definitions of cam-type morphotype should be used with care.
利用高分辨率计算机断层扫描（CT）确定正常髋关节中股骨髋臼撞击症（FAI）定量形态学参数的均值及参考区间。
我们前瞻性纳入了94例因胸部、腹部或泌尿系统疾病接受CT检查的成年个体。排除有髋关节疾病临床病史和/或CT显示有骨关节炎的患者。我们计算了凸轮型（90°和45°时的α角以及股骨头颈偏移）和钳夹型撞击（髋臼旋转角、外侧中心边缘角和髋臼指数）影像学征象的均值及95%参考区间。
95%参考区间界限均远高于文献中报道的凸轮型异常阈值，而钳夹型FAI的异常阈值略低。α角（90°/45°时）参考区间的上限男性为68°/83°，女性为69°/84°，而文献中的阈值为（50°、55°或60°）。凸轮型参数的参考区间在性别间相似，而钳夹型参数的参考区间略有差异。
无症状髋关节中FAI形态学测量的95%参考区间超出了异常阈值，凸轮型FAI尤其如此。我们的结果表明需要重新定义目前用于FAI诊断的形态学参数。
• FAI形态类型的95%参考区间界限超出了目前定义的阈值。• 钳夹型形态类型测量的参考区间接近目前的定义。• 凸轮型形态类型测量的参考区间远超出目前的定义。• 目前凸轮型形态类型的形态学定义应谨慎使用。
