凸轮型股骨髋臼撞击症-α 角与容积测量值和手术发现的相关性。
Cam-type femoroacetabular impingement-correlations between alpha angle versus volumetric measurements and surgical findings.
机构信息
Department of Radiology, Zagazig University Hospitals and Faculty of Medicine, Zagazig University, Koliat Al Tob Street, Zagazig, 44519, Egypt.
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
Eur Radiol. 2019 Jul;29(7):3431-3440. doi: 10.1007/s00330-018-5968-z. Epub 2019 Feb 11.
AIM
Determine correlations of 3DCT cam-type femoroacetabular impingement (FAI) measurements with surgical findings of labral tear and cartilage loss.
METHODS
Digital search of symptomatic cam-type FAI from July 2013 to August 2016 yielded 43 patients. Two readers calculated volumes of femoral head, bump, and alpha angles on 3DCT images. Correlations between CT and surgical findings, inter-, and intra-reader reliabilities were assessed using Spearman rank correlation and intraclass correlation coefficients (ICC).
RESULTS
Thirteen men and 14 women aged 37 ± 10 (mean ± SD) years were included. Most common clinical finding was positive flexion-adduction-internal rotation (70.4%). Twenty-seven labral tears and 20 cartilage defects were surgically detected. Significant correlations existed between femoral bump, head volumes, and extent of the labral tear (p = 0.008 and 0.003). No significant correlations were found between the alpha angles at 12 to 3 o'clock and the extent of labral tear (p = 0.2, 0.8, 0.9, and 0.09) or any measurement with the cartilage loss (p values for alpha 12 to 3, bump, and head volumes = 0.7, 0.3, 0.9, 0.9, 0.07, and 0.2). Inter- and intra-reader reliabilities were excellent to moderate for femoral head and bump volumes (ICC = 0.85, 0.52, and 0.8, 0.5) and moderate to poor for alpha angles (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49).
CONCLUSION
Three dimensional volumetric measurements of cam-type FAI significantly correlate with the extent of intraoperative labral tears. Superior inter- and intra-reader reliability to that of alpha angles renders it a more clinically relevant measurement for quantifying cam morphology.
KEY POINTS
• The 3DCT bump volume and femoral head volume showed significant correlations with the extent of labral tear (p values = 0.008 and 0.003). • No significant correlations were seen between alpha angles and the extent of labral tear (p values > 0.05). • Inter- and intra-reader reliability was excellent to moderate (ICC = 0.85 and 0.52, 0.8, and 0.5) for femoral head and bump volumes while inter- and intra-reader reliability was fair to poor (ICC = 0.48, 0.40, 0.05, 0.25 and 0.3, 0.24, 0.29, 0.49) for alpha angles.
目的
确定 3DCT 凸轮型股骨髋臼撞击症（FAI）测量与关节镜下发现的盂唇撕裂和软骨损伤的相关性。
方法
从 2013 年 7 月至 2016 年 8 月，对有症状的凸轮型 FAI 进行数字搜索，共纳入 43 例患者。两位读者在 3DCT 图像上计算股骨头、骨突和 alpha 角的体积。使用 Spearman 秩相关和组内相关系数（ICC）评估 CT 与手术结果之间的相关性，以及读者之间和读者内部的可靠性。
结果
纳入 13 名男性和 14 名女性，年龄 37±10（均值±标准差）岁。最常见的临床发现是阳性的屈伸内收内旋（70.4%）。27 例盂唇撕裂和 20 例软骨缺损在手术中发现。股骨骨突、股骨头体积与盂唇撕裂程度存在显著相关性（p=0.008 和 0.003）。alpha 角在 12 点至 3 点与盂唇撕裂程度之间无显著相关性（p=0.2、0.8、0.9 和 0.09），或与任何软骨损伤之间无相关性（alpha 角在 12 点至 3 点、骨突和股骨头体积的 p 值=0.7、0.3、0.9、0.9、0.07 和 0.2）。股骨头和骨突体积的读者间和读者内可靠性为优至中度（ICC=0.85、0.52 和 0.8、0.5），alpha 角的可靠性为差至中度（ICC=0.48、0.40、0.05、0.25 和 0.3、0.24、0.29、0.49）。
结论
凸轮型 FAI 的三维容积测量与术中盂唇撕裂程度显著相关。优于 alpha 角的读者间和读者内可靠性使其成为量化凸轮形态的更具临床相关性的测量方法。
关键点
3DCT 骨突体积和股骨头体积与盂唇撕裂程度呈显著相关（p 值分别为 0.008 和 0.003）。
alpha 角与盂唇撕裂程度之间无显著相关性（p 值>0.05）。
股骨头和骨突体积的读者间和读者内可靠性为优至中度（ICC=0.85 和 0.52，0.8 和 0.5），alpha 角的读者间和读者内可靠性为差至中度（ICC=0.48、0.40、0.05、0.25 和 0.3、0.24、0.29、0.49）。
Zotero 插件