Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 2019 Dec;47(14):3460-3468. doi: 10.1177/0363546519878170. Epub 2019 Oct 21.
Femoroacetabular impingement syndrome (FAIS) is a common disorder of the hip resulting in groin pain and ultimately osteoarthritis. Radiologic assessment of FAI morphologies, which may present with overlapping radiologic features of hip dysplasia, often requires the use of computed tomography (CT) for evaluation of osseous abnormality, owing to the difficulty of direct visualization of cortical and subchondral bone with conventional magnetic resonance imaging (MRI). The use of a zero echo time (ZTE) MRI pulse sequence may obviate the need for CT by rendering bone directly from MRI.
PURPOSE/HYPOTHESIS: The purpose was to explore the application of ZTE MRI to the assessment of osseous FAI and dysplasia morphologies of the hip. It was hypothesized that angular measurements from ZTE images would show significant agreement with measurements obtained from CT images.
Cohort study (diagnosis); Level of evidence, 2.
Thirty-eight hips from 23 patients were imaged with ZTE MRI and CT. Clinically relevant angular measurements of hip morphology were made in both modalities and compared to assess agreement. Measurements included coronal and sagittal center-edge angles, femoral neck-shaft angle, acetabular version (at 1-, 2-, and 3-o'clock positions), Tönnis angle, alpha angle, and modified-beta angle. Interrater agreement was assessed for a subset of 10 hips by 2 raters. Intermodal agreement was assessed on the complete cohort and a single rater.
Interrater agreement was demonstrated in both CT and ZTE, with intraclass correlation coefficient values ranging from 0.636 to 0.990 for ZTE and 0.747 to 0.983 for CT, indicating "good" to "excellent" agreement. Intermodal agreement was also shown to be significant, with intraclass correlation coefficients ranging from 0.618 to 0.904.
Significant agreement of angular measurements for hip morphology exists between ZTE MRI and CT imaging. ZTE MRI may be an effective method to quantitatively evaluate osseous hip morphology.
髋关节撞击综合征（FAIS）是一种常见的髋关节疾病，可导致腹股沟疼痛，最终发展为骨关节炎。FAIS 形态的放射学评估，可能与髋关节发育不良的放射学特征重叠，通常需要使用计算机断层扫描（CT）来评估骨异常，因为常规磁共振成像（MRI）很难直接观察皮质和软骨下骨。使用零回波时间（ZTE）MRI 脉冲序列可以通过直接从 MRI 呈现骨骼来避免对 CT 的需求。
目的/假设：目的是探讨 ZTE MRI 在评估髋关节骨 FAIS 和发育不良形态中的应用。假设 ZTE 图像的角度测量值与 CT 图像的测量值具有显著一致性。
队列研究（诊断）；证据水平，2。
对 23 例患者的 38 髋进行 ZTE MRI 和 CT 成像。在两种模式下对髋关节形态的临床相关角度测量值进行测量，并进行比较以评估一致性。测量包括冠状和矢状中心边缘角、股骨颈干角、髋臼方位（1、2、3 点钟位置）、Tönnis 角、α 角和改良-β 角。由 2 名评分者对 10 髋的亚组进行了组内一致性评估。对完整队列和单个评分者进行了模态间一致性评估。
在 CT 和 ZTE 中均显示出组内一致性，ZTE 的组内相关系数值范围为 0.636 至 0.990，CT 的组内相关系数值范围为 0.747 至 0.983，表明具有“良好”至“优秀”的一致性。模态间一致性也显示出显著的一致性，组内相关系数值范围为 0.618 至 0.904。
ZTE MRI 和 CT 成像之间存在髋关节形态角度测量的显著一致性。ZTE MRI 可能是一种有效评估骨髋关节形态的定量方法。
