摘要
坐骨股骨撞击综合征(ischiofemoral impingement syndrome, IFI)是一种比预期更常见的髋关节外撞击综合征,临床表现缺乏特异性,极易与梨状肌综合征、腰椎间盘突出症等混淆。MRI既可测量与IFI相关的径线、角度,还能定量或半定量评估相关骨骼肌的面积、体积及信号,已成为IFI的首选检查方法。运动范围MRI有助于减少体位因素对解剖形态学参数的影响,提高了评估IFI的敏感性和准确性;动态MRI和三维MRI的联合应用,能在获取实际运动过程中IFI相关解剖结构功能信息的同时,更真实地反映解剖结构在三维空间中的位置关系,将进一步提高诊断的全面性和准确性;功能MRI(functional MRI, fMRI)可通过测量水分子扩散和微循环灌注、脂肪浸润、物质代谢等股方肌、髋外展肌的微观水平定量指标,使IFI的精准诊断及预测、运动功能监测等成为可能,有望成为IFI临床诊疗新的研究方向。本文将阐述多种MRI和fMRI技术在定量评估IFI的应用研究,总结其优点及缺点,为临床全面、精准评估IFI的发生、进展及转归提供参考。
Ischiofemoral impingement syndrome(IFI)is a type of extra-articular hip impingement that is more common than anticipated,the lack of specificity in clinical presentation makes,it easily confused with other conditions like piriformis syndrome and lumbar disc herniation.MRI is capable of measuring dimensions and angles associated with IFI and can also provide quantitative or semi-quantitative assessments of the size and signal intensity of the relevant skeletal muscles,making it the preferred diagnostic modality for IFI.Range of motion MRI helps to reduce the impact of positional factors on morphological parameters,improving the sensitivity and accuracy of IFI diagnosis;the combined application of dynamic MRI and three-dimensional MRI can obtain functional information of IFI-related anatomical structures during actual movement,while more truly reflecting the spatial relationship of anatomical structures in three-dimensional space,which will further improve the comprehensiveness and accuracy of diagnosis.Functional MRI(fMRI)can measure the water molecule diffusion,microcirculation status,the extent of fat infiltration,muscle fiber orientation,and metabolic levels of the quadratus femoris and hip abductor muscles,making precise diagnosis and prediction of IFI,as well as monitoring of movement function,possible,and is expected to become a new research direction for the clinical diagnosis and treatment of IFI.This review will elaborate on the application of various MRI and fMRI technologies in the quantitative assessment of IFI,summarize their advantages and disadvantages,and provide references for the comprehensive and precise assessment of the occurrence,progression,and outcome of IFI using multi-parameter joint application of MRI and fMRI.
作者
刘玥
李红
万兵
田第娇
徐敬星
赵家源
王玟
LIU Yue;LI Hong;WAN Bing;TIAN Dijiao;XU Jingxing;ZHAO Jiayuan;WANG Wen(Department of Radiology,Renhe Hospital affiliated to China Three Gorges University,Yichang 443001,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第7期227-234,共8页
Chinese Journal of Magnetic Resonance Imaging
基金
2022年度湖北省教育厅科学研究计划项目(编号:B2022032)。
关键词
坐骨股骨撞击综合征
磁共振成像
功能磁共振成像
动态三维成像
骨骼肌
ischiofemoral impingement syndrome
magnetic resonance imaging
functional magnetic resonance imaging
dynamic three-dimensional imaging
skeletal muscle
