摘要
背景:近期研究发现在具有股骨颈疝窝的患者,其股骨颈α角显著增大,但股骨颈疝窝能否作为髋关节撞击综合征的影像学诊断指标尚存在争议。目的:评估无髋关节症状成年人股骨颈α角与股骨颈疝窝的相关性,以及上述指标变异的影响因素,为髋关节撞击综合征的诊断提供依据。方法:自2013年9月至2015年12月招募无髋关节症状的成年人纳入研究,利用斜向MRI测量股骨颈α角,利用MRI检查检测股骨颈疝窝的发生率以及大小。统计分析股骨颈α角、股骨颈疝窝发生率、大小等与年龄、性别、患侧分布的相关性。利用ICC系数评估观察者间以及观察者自身对股骨颈α角测量的一致性。结果与结论:(1)共105例无髋关节症状的研究对象入组,共计获得185侧符合研究要求的髋部MRI图像,研究对象年龄范围为18-80岁,股骨颈疝窝发生率为21.6%;(2)股骨颈α角的分布范围为27.6°-65°。共17例研究对象的股骨颈α角≥55°;(3)股骨颈α角≥55°与股骨颈疝窝发生率以及疝窝大小无相关性(P>0.05),股骨颈疝窝发生与年龄、性别以及患侧分布无相关性(P=0.160,0.157,0.110)。股骨颈α角的观察者间一致性为0.523,观察者自身一致性为0.654;(4)结果提示,当α角临界值为55°时,股骨颈α角增大与股骨颈疝窝的发生及其程度无相关性,与年龄、性别以及患侧分布无相关性。临床发现股骨颈α角增大与股骨颈疝窝需谨慎对待,用于髋关节撞击综合征诊断时需要结合临床症状和其他检查。
BACKGROUND： Recent studies have found that femoral neck angle α in patient with femoral neck hernial fossa increased significantly. However, whether the femoral neck hernia fossa can be used as imaging diagnostic indicator for femoroacetabular impingement syndrome remains controversial. OBJECTIVE： To evaluate the association between alpha angle and herniation pit in asymptomatic hip joints, influencing factors of the above indexes, and to provide evidence for the diagnosis of hip impingement syndrome. METHODS： Adults with asymptomatic hip joints from September 2013 to December 2015 were retrospectively studied. Alpha angles were measured on oblique axial MRI images. The incidence and size of herniation pit were determined by MRI. Size measures, prevalence, and statistical analyses were conducted regarding its association with age, gender, laterality（right or left hip）. Intra-and inter-observer consistency was determined by intra-class correlation coefficient. RESULTS AND CONCLUSION：（1） 105 patients with asymptomatic hips were included, and 185 sides of hip MRI images were obtained. The range of age was 18-80 years old. The prevalence of herniation pit in asymptomatic hips was 21.6%.（2） The range of alpha angle was 27.6°–65.0°. Alpha angles of hip joints of 17 cases were ≥ 55°.（3） There was no association between alpha angle ≥ 55° and the size of herniation pit（P〉 0.05）. The prevalence of herniation pit was not correlated with age, gender and affected side（P=0.160, 0.157, 0.110）. Inter-observer consistency of alpha angle was 0.523 between first measurements of first vs. second observer, respectively. Intra-observer consistency of alpha angle was 0.654, respectively.（4） There is no association between alpha angle ≥ 55 degrees and presence of herniation pit or demographic variables（age, gender and affected side）. The presence of herniation pit and the increased alpha angle need to be interpreted with caution. Clinical symptoms and other examinations should be used in the diagnosis of hip impingement syndrome.
出处
《中国组织工程研究》
CAS
北大核心
2017年第7期1098-1103,共6页
Chinese Journal of Tissue Engineering Research
基金
郑州大学第一附属医院影像科对课题的支持
