Nishii T, Nakanishi K, Sugano N, Naito H, Tamura S, Ochi T
Division of Functional Diagnosic Imaging, Biomedical Research Center, Osaka University Medical School, Japan.
Skeletal Radiol. 1996 May;25(4):349-56. doi: 10.1007/s002560050094.
The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears.
Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques.
Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning.
本研究的目的是评估持续腿部牵引对髋关节对比增强磁共振成像的影响，并确定在此条件下的磁共振成像是否有助于显示髋臼唇撕裂。
19个髋关节接受了T1加权自旋回波序列的磁共振成像，然后在静脉注射钆喷酸葡胺后进行持续腿部牵引下的磁共振成像。评估关节液增强和唇轮廓检测情况。11个髋关节通过传统关节造影、关节镜检查和宏观手术结果显示存在唇撕裂。通过磁共振成像对唇撕裂的评估与基于这些标准技术的诊断相关。
注射后30分钟时，所有髋关节均获得了关节液增强。在未增强的磁共振图像上，1个髋关节的上唇和下唇表面完全清晰显示，在牵引下的增强图像上，分别有7个和13个髋关节的上唇和下唇表面完全清晰显示。牵引下的增强图像显示了11个唇撕裂中的9个。未增强图像与牵引下增强图像的比较避免了4个髋关节将唇的切迹误判为撕裂。牵引下的对比增强磁共振成像对于无创且无辐射地检测唇撕裂很有价值。在髋臼发育不良患者中使用这种方法进行随访检查有助于明确唇疾病的自然病程，并有助于制定更好的治疗方案。
