Hesper Tobias, Neugroda Christina, Schleich Christoph, Antoch Gerald, Hosalkar Harish, Krauspe Rüdiger, Zilkens Christoph, Bittersohl Bernd
1 Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
2 Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Cartilage. 2018 Apr;9(2):118-126. doi: 10.1177/1947603517741168. Epub 2017 Nov 10.
Objective To evaluate the diagnostic accuracy of T2*-mapping for detecting acetabular cartilage damage in patients with symptomatic femoroacetabular impingement (FAI). Design A total of 29 patients (17 females, 12 males, mean age 35.6 ± 12.8 years, mean body mass index 25.1 ± 4.1 kg/m, 16 right hips) with symptomatic FAI underwent T2* MRI and subsequent hip arthroscopy. T2* values were obtained by region of interest analysis in seven radially reformatted planes around the femoral neck (anterior, anterior-superior, superior-anterior, superior, superior-posterior, posterior-superior, posterior). Intraoperatively, a modified Outerbridge classification was used for assessment of the cartilage status in each region. T2* values and intraoperative data were compared, and sensitivity, specificity, negative predictive values (NPV) and positive predictive values (PPV) as well as the correlation between T2*-mapping and intraoperative findings, were determined. The mean time interval between MRI and arthroscopy was 65.7 ± 48.0 days. Results Significantly higher T2* values were noted in arthroscopically normal evaluated cartilage than in regions with cartilage degeneration (mean T2* 25.6 ± 4.7 ms vs. 19.9 ± 4.5 ms; P < 0.001). With the intraoperative findings as a reference, sensitivity, specificity, NPV and PPV were 83.5%, 67.7%, 78.4% and 74.4%, respectively. The correlation between T2*-mapping and intraoperative cartilage status was moderate (ρ = -0.557; P < 0.001). Conclusions T2*-mapping enabled analysis of acetabular cartilage with appropriate correlation with intraoperative findings and promising results for sensitivity, specificity, PPV, and NPV in this cohort. Our results emphasize the value of T2*-mapping for the diagnosis of hip joint cartilage pathologies in symptomatic FAI.
目的 评估T2* 映射成像在检测有症状的股骨髋臼撞击症（FAI）患者髋臼软骨损伤中的诊断准确性。设计 共有29例有症状的FAI患者（17例女性，12例男性，平均年龄35.6±12.8岁，平均体重指数25.1±4.1kg/m²，16例右髋）接受了T2* 磁共振成像（MRI）检查及随后的髋关节镜检查。通过在股骨颈周围七个径向重格式化平面上进行感兴趣区域分析获得T2* 值（前侧、前上侧、上前方、上方、上后侧、后上侧、后侧）。术中，采用改良的Outerbridge分类法评估每个区域的软骨状况。比较T2* 值与术中数据，并确定敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）以及T2* 映射成像与术中发现之间的相关性。MRI与关节镜检查之间的平均时间间隔为65.7±48.0天。结果 关节镜检查评估为正常的软骨区域的T2* 值显著高于存在软骨退变的区域（平均T2* 为25.6±4.7毫秒对19.9±4.5毫秒；P<0.001）。以术中发现为参考，敏感性、特异性、NPV和PPV分别为83.5%、67.7%、78.4%和74.4%。T2* 映射成像与术中软骨状况之间的相关性为中等（ρ=-0.557；P<0.001）。结论 T2* 映射成像能够对髋臼软骨进行分析，与术中发现具有适当的相关性，并且在该队列中其敏感性、特异性、PPV和NPV均有良好结果。我们的结果强调了T2* 映射成像在诊断有症状FAI患者髋关节软骨病变中的价值。
