在股骨髋臼撞击综合征患者中，三维计算机断层扫描重建检测钳夹性损伤的灵敏度可能高于X线片。
Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome.
作者信息
Smith Cory D, Simpson Evan, Johnson Bailey, Quilligan Edward, Grumet Robert, Parvaresh Kevin C
机构信息
Hoag Orthopedic Institute, Irvine, California, U.S.A.
出版信息
Arthrosc Sports Med Rehabil. 2024 Feb 28;6(3):100918. doi: 10.1016/j.asmr.2024.100918. eCollection 2024 Jun.
PURPOSE
To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
METHODS
We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under "select criteria," patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas "all criteria" added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs.
RESULTS
A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria.
CONCLUSIONS
In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone.
LEVEL OF EVIDENCE
Level III, retrospective cohort study.
目的
在因股骨髋臼撞击综合征（FAIS）接受髋关节镜检查的患者中，评估X线片（XR）与三维（3D）计算机断层扫描相比检测钳夹性病变的诊断能力。
方法
我们对2020年9月1日至2022年10月2日期间因FAIS接受髋关节镜检查的所有患者进行了回顾性研究。回顾术前影像学检查。钳夹性病变定义为外侧中心边缘角大于40°；Tönnis角大于0°；存在坐骨棘、交叉或后壁征；以及存在大于80%的覆盖过度。在“选择标准”下，仅根据外侧中心边缘角或Tönnis角，将患者在XR和3D计算机断层扫描重建（CTR）上分类为患有钳夹性病变，而“所有标准”则增加了交叉征和覆盖百分比的存在。进行统计分析以确定XR与3D CTR相比的诊断准确性。
结果
共有69例患者符合纳入标准。其中男性患者21例（30.4%），女性患者48例（69.6%）。平均年龄为33±13.5岁。选择标准的χ分析发现，3D CTR比XR更有可能检测到钳夹性病变。所有标准的χ分析发现，3D CTR比XR更有可能检测到钳夹性病变。χ分析进一步表明，使用XR时，在所有标准下比在选择标准下更有可能检测到钳夹性病变。同样，使用3D CTR时，在所有标准下比在选择标准下更有可能检测到钳夹性病变。
结论
在本研究中，我们发现3D CTR在因FAIS接受髋关节镜检查的患者中检测钳夹性病变的敏感性明显高于单独使用XR。
证据水平
III级，回顾性队列研究。
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