Triana Jairo, Shankar Dhruv S, Moore Michael A, Akpinar Berkcan, Vasavada Kinjal D, Burke Christopher J, Samim Mohammad M, Youm Thomas
Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA.
Knee Surg Sports Traumatol Arthrosc. 2025 Mar;33(3):1091-1103. doi: 10.1002/ksa.12446. Epub 2024 Sep 11.
The aim of this study was to assess the inter-rater reproducibility and inter-method comparability of hip alpha angle measurements on magnetic resonance imaging (MRI)/magnetic resonance arthrography (MRA) and plain radiographs in patients with femoroacetabular impingement syndrome (FAIS).
A cross-sectional study of patients who were diagnosed with symptomatic FAIS underwent preoperative MRI/MRA with axial oblique and/or radial plane imaging and had preoperative radiographs with anterior-posterior (AP), 45° Dunn and 90° Dunn views. Alpha angle measurements were performed independently by two musculoskeletal radiologists. Inter-rater reproducibility and inter-method comparability between MRI/MRA images and radiographic views were assessed using the intraclass correlation coefficient (ICC) with 95% confidence interval (CI).
Ninety-seven patients were included of whom 93 (95.8%) received axial oblique plane images and 54 (55.6%) had radial plane MRI/MRA images. Inter-rater reproducibility was excellent (ICC > 0.9) for all planes on MRI/MRA and radiographs. MRI/MRA axial oblique images had poor (ICC 0.39, 95% CI [0.09, 0.59]), moderate (ICC 0.57, 95% CI [0.18, 0.75]) and moderate (ICC 0.64, 95% CI [0.20, 0.81]) comparability with AP, 45° Dunn and 90° Dunn, respectively. MRI/MRA radial plane images had equivocal (0 included in all CIs) comparability with AP (ICC 0.66), 45° Dunn (ICC 0.35) and 90° Dunn (ICC 0.14) radiographs. On average, alpha angle measurements were significantly higher with radial images and lower with axial oblique images, when compared to all radiographic views (p < 0.05), except axial oblique versus 45° Dunn views, where angles measured on axial oblique were significantly larger.
Alpha angle measurements taken on axial oblique MRI/MRA images show moderate comparability to radiographic 45° Dunn and 90° Dunn views despite negative bias to measurements taken on radiographic AP and 45° Dunn view. Larger alpha angles were appreciated on MRI/MRA radial and axial oblique views compared to radiographic views supporting the inclusion of MRI/MRA alpha angle measurements to properly identify deformity.
Level II.
本研究旨在评估股骨髋臼撞击综合征（FAIS）患者在磁共振成像（MRI）/磁共振关节造影（MRA）及X线平片上髋关节α角测量的评分者间再现性和方法间可比性。
对诊断为有症状FAIS的患者进行横断面研究，这些患者术前接受了轴向斜位和/或径向平面成像的MRI/MRA检查，并拍摄了前后位（AP）、45°邓恩位和90°邓恩位的术前X线片。由两名肌肉骨骼放射科医生独立进行α角测量。使用组内相关系数（ICC）及95%置信区间（CI）评估MRI/MRA图像与X线片视图之间的评分者间再现性和方法间可比性。
纳入97例患者，其中93例（95.8%）接受了轴向斜位平面图像检查，54例（55.6%）有径向平面MRI/MRA图像。MRI/MRA及X线片所有平面的评分者间再现性均极佳（ICC＞0.9）。MRI/MRA轴向斜位图像与AP、45°邓恩位和90°邓恩位的可比性分别较差（ICC 0.39，95% CI [0.09, 0.59]）、中等（ICC 0.57，95% CI [0.18, 0.75]）和中等（ICC 0.64，95% CI [0.20, 0.81]）。MRI/MRA径向平面图像与AP（ICC 0.66）、45°邓恩位（ICC 0.35）和90°邓恩位（ICC 0.14）X线片的可比性不明确（所有CI均包含0）。与所有X线片视图相比，平均而言，径向图像的α角测量值显著更高，轴向斜位图像的α角测量值显著更低（p＜0.05），轴向斜位与45°邓恩位视图除外，轴向斜位测量的角度显著更大。
尽管轴向斜位MRI/MRA图像上的α角测量值与X线片45°邓恩位和90°邓恩位视图相比存在负偏差，但仍显示出中等可比性。与X线片视图相比，MRI/MRA径向和轴向斜位视图上的α角更大，这支持将MRI/MRAα角测量纳入以正确识别畸形。
II级。
