Akkaya Zehra, Giesler Paula J, Roach Koren E, Joseph Gabby B, McCulloch Charles E, Bharadwaj Upasana U, Souza Richard B, Majumdar Sharmila, Link Thomas M
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey.
Eur Radiol. 2025 Apr;35(4):2275-2286. doi: 10.1007/s00330-024-11030-w. Epub 2024 Aug 23.
To investigate the association between magnetic resonance imaging (MRI)-based ligamentum teres lesions (LTL) and structural hip degeneration.
Bilateral 3-T hip MRIs of participants (n = 93 [36 men]; mean age ( ± SD) 51 years ± 15.4) recruited from the community and the orthopedic clinic of a single medical center were included. Clinical and imaging data acquired included hip disability and osteoarthritis outcome scores, semi-quantitative scoring of hip osteoarthritis on MRI (SHOMRI) scores on fluid-sensitive sequences, and cartilage T/T compositional sequences. An MRI-based LTL scoring system, incorporating continuity, thickening, and signal intensity, ranging from 0 (normal) to 4 (complete tear) was constructed. Hip morphological features associated with LTL, based on functional or anatomical relationships to LT, were defined. Relationships between MRI-LT scores and SHOMRI, global/regional cartilage T/T, and proposed morphological abnormalities and LTL were explored by mixed effects linear and logistic regression models.
In 82 (46.1%) hips, no pain was documented; 118 (63.4%) and 68 (36.6%) hips were graded as KL-grade ≤ 1 and ≥ 2, respectively. Compared to MRI-LT score = 0 (normal), score = 4 (complete tear) revealed significantly worse subchondral bony degenerative changes for bone marrow lesions (SHOMRI-BML) and subchondral cysts (SHOMRI-sc) (p < 0.001, p = 0.015, respectively). Global acetabular T, femoral T were significantly increased for abnormal MRI-LT scores (p-range = 0.005-0.032). Regional analyses revealed significantly increased T/T in central acetabular/increased T in off-central femoral regions (p-range = 0.005-0.046). Pulvinar effusion-synovitis, shallow fovea, and foveal osteophytes were significantly associated with abnormal LT MRI findings (p-range = < 0.001-0.044).
MRI abnormalities of LT are associated with worse SHOMRI-sc/BML scores, indicative of hip osteoarthritis and higher T and T that differ by region. Pulvinar effusion-synovitis and changes in femoral head morphology are associated with LTL.
Abnormal ligamentum teres findings identified via MRI are associated with structural degenerative changes of the hip joint and alterations in acetabular and femoral cartilage compositions show spatial differences in relation to LTL.
The clinical significance of common ligamentum teres lesions (LTL) on MRI is not well understood. LTL identified by an MRI-based scoring system is associated with worse biomarkers, indicating more advanced degenerative hip changes. Effusion-synovitis signal at pulvinar, shallow fovea capitis, and foveal osteophytes are associated with LTL on imaging.
研究基于磁共振成像（MRI）的圆韧带损伤（LTL）与髋关节结构退变之间的关联。
纳入从社区及某单一医疗中心骨科门诊招募的参与者的双侧3-T髋关节MRI数据（n = 93[36名男性]；平均年龄（±标准差）51岁±15.4岁）。采集的临床和影像数据包括髋关节功能障碍和骨关节炎结局评分、液体敏感序列上髋关节骨关节炎的半定量评分（SHOMRI）、以及软骨T/T成分序列。构建了基于MRI的LTL评分系统，该系统综合连续性、增厚和信号强度，范围从0（正常）到4（完全撕裂）。根据与圆韧带的功能或解剖关系，定义了与LTL相关的髋关节形态学特征。通过混合效应线性和逻辑回归模型，探讨MRI-LT评分与SHOMRI、整体/局部软骨T/T以及所提出的形态学异常和LTL之间的关系。
在82个（46.1%）髋关节中，无疼痛记录；118个（63.4%）和68个（36.6%）髋关节分别被评为KL分级≤1级和≥2级。与MRI-LT评分为0（正常）相比，评分为4（完全撕裂）时，骨髓病变（SHOMRI-BML）和软骨下囊肿（SHOMRI-sc）的软骨下骨退行性改变明显更严重（分别为p < 0.001，p = 0.015）。MRI-LT评分异常时，髋臼整体T值、股骨整体T值显著增加（p值范围为0.005 - 0.032）。局部分析显示，髋臼中央T/T显著增加/股骨偏心区域T值增加（p值范围为0.005 - 0.046）。髋臼垫积液-滑膜炎、浅髋臼窝和髋臼窝骨赘与圆韧带MRI异常表现显著相关（p值范围为< 0.001 - 0.044）。
圆韧带的MRI异常与更差的SHOMRI-sc/BML评分相关，提示髋关节骨关节炎，且T值更高，不同区域存在差异。髋臼垫积液-滑膜炎和股骨头形态改变与LTL相关。
通过MRI识别的圆韧带异常与髋关节的结构退行性改变相关，髋臼和股骨软骨成分的改变与LTL存在空间差异。
MRI上常见圆韧带损伤（LTL）的临床意义尚未完全明确。基于MRI评分系统识别的LTL与更差的生物标志物相关，表明髋关节退变更严重。髋臼垫的积液-滑膜炎信号、浅股骨头凹和髋臼窝骨赘在影像学上与LTL相关。
