髋关节撞击综合征患者行磁共振成像或磁共振关节造影检查时髋臼唇撕裂和盂唇旁囊肿的位置及相关性。
Location and Correlation of Acetabular Labral Tears and Paralabral Cysts Using Magnetic Resonance Imaging or Magnetic Resonance Arthrography in Patients With Femoroacetabular Impingement.
机构信息
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
出版信息
Arthroscopy. 2019 Mar;35(3):809-815. doi: 10.1016/j.arthro.2018.10.141. Epub 2019 Feb 4.
PURPOSE
To evaluate the prevalence and location of paralabral cysts and the correlation between the type of femoroacetabular impingement (FAI) and acetabular labral tears, as well as the location of the paralabral cysts.
METHODS
Patients who received a diagnosis of FAI syndrome using plain radiography, magnetic resonance imaging or magnetic resonance arthrography, or computed tomographic arthrography from 2010 to 2015 were included in this study. The exclusion criteria were patients with arthritis (Tönnis grade 2 or greater) or dysplasia. We identified paralabral cysts and their location, size, configuration. Correlations between the type of FAI and labral tears and paralabral cysts were analyzed using the χ-square test.
RESULTS
Among 506 patients with FAI, paralabral cysts were found in 51 patients (55 hips) and were located anterosuperiorly in 40% of cases, posterosuperiorly in 36%, anteroinferiorly in 17%, and posteroinferiorly in 8%. We identified multilocular cysts in 60% of hips and unilocular cysts in 40%. Labral tears were radiographically found in 44 of 55 hips with paralabral cysts (80%); they were located anterosuperiorly in 59% and posterosuperiorly in 41%. Although paralabral cysts were found in the anteroinferior and posteroinferior areas, acetabular labral tears were not identified in the anteroinferior and posteroinferior areas. Classification of the type of FAI showed cam type in 14 of 55 hips (25.5%), pincer type in 16 (29%), mixed type in 7 (13%), labral tears in 15 (27%), and normal findings in 3 (5.5%). No correlation was found between the type of FAI and labral tears (P = .739) or the location of paralabral cysts (P = .228).
CONCLUSIONS
Paralabral cysts in patients with FAI most commonly are found in the anterosuperior area and are of the multilocular type. Although paralabral cysts in the anterosuperior and posterosuperior portions are related to labral tears, those in the anteroinferior and posteroinferior portions are not.
LEVEL OF EVIDENCE
Level IV, diagnostic case series.
目的
评估盂唇旁囊肿的发生率和位置，以及其与股骨髋臼撞击症（FAI）类型和髋臼唇撕裂的相关性，同时评估盂唇旁囊肿的位置。
方法
本研究纳入了 2010 年至 2015 年间通过普通 X 线摄影、磁共振成像或磁共振关节造影或计算机断层扫描关节造影诊断为 FAI 综合征的患者。排除标准为关节炎（Tönnis 分级 2 级或更高级别）或发育不良患者。我们确定了盂唇旁囊肿及其位置、大小和形态。使用卡方检验分析 FAI 类型与盂唇撕裂和盂唇旁囊肿之间的相关性。
结果
在 506 例 FAI 患者中，51 例（55 髋）发现盂唇旁囊肿，前上侧占 40%，后上侧占 36%，前下侧占 17%，后下侧占 8%。我们发现 60%的髋关节为多房性囊肿，40%为单房性囊肿。在 55 例有盂唇旁囊肿的髋关节中，44 例（80%）放射学上发现了盂唇撕裂，其中 59%位于前上侧，41%位于后上侧。尽管在前下和后下区域发现了盂唇旁囊肿，但在前下和后下区域未发现髋臼唇撕裂。FAI 类型的分类显示 14 髋（25.5%）为凸轮型，16 髋（29%）为钳夹型，7 髋（13%）为混合型，15 髋（27%）为盂唇撕裂，3 髋（5.5%）为正常。FAI 类型与盂唇撕裂（P=0.739）或盂唇旁囊肿的位置（P=0.228）之间无相关性。
结论
在 FAI 患者中，盂唇旁囊肿最常见于前上区域，且多为多房性。尽管前上和后上部分的盂唇旁囊肿与盂唇撕裂有关，但前下和后下部分的盂唇旁囊肿与盂唇撕裂无关。
证据等级
IV 级，诊断性病例系列。
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