Magnetic resonance imaging of the hip: Detection of labral and chondral abnormalities using noncontrast imaging
Magnetic resonance imaging of the hip: Detection of labral and chondral abnormalities using noncontrast imaging
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DOI：
10.1016/j.arthro.2004.12.011
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发表时间：
2005-04-01
影响因子：
4.7
通讯作者：
Potter, HG
中科院分区：
文献类型：
--
作者：
Mintz, DN;Hooper, T;Potter, HG
目的：传统成像技术检测髋关节细微软骨和盂唇损伤的能力有限。我们对接受髋关节磁共振成像 (MRI) 和随后的髋关节镜检查的患者进行了回顾性审查，以评估优化的非对比 MRI 识别髋臼盂唇撕裂和关节软骨缺陷的能力。研究类型：对连续样本的回顾性审查。方法：1997 年 1 月至 2000 年 7 月期间，对 92 名患者进行了髋部 MRI 检查，随后由 2 名外科医生中的 1 名（R.B.、D.E.P.）对该髋关节进行了关节镜手术。两名肌肉骨骼 MR 放射科医生对最初的 MRI 和手术结果不知情，独立解释了这些研究，寻找关节软骨和髋臼盂唇病理的位置和程度。结果：在研究的 92 名患者中，2 名放射科医生分别正确识别了手术中出现的 88 例盂唇撕裂中的 83 例 (94%) 和 84 例 (95%)。 MRI 研究的观察者间一致性达到 92%。对于股骨头和髋臼的关节软骨缺损，MRI 和手术分级之间以及 2 名 MR 读数器之间具有良好的一致性（92% 和 86% 在 1 级以内）（股骨头软骨的 kappa 为 0.8，髋臼软骨的 kappa 为 0.7）。结论：本研究表明，使用优化方案的髋部非对比 MRI 可以无创地识别盂唇和软骨病理。这些信息可能有助于决定哪些患者需要手术干预，从而保留髋关节镜作为一种治疗工具。
Purpose: Traditional imaging techniques have limited ability to detect subtle chondral and labral injuries of the hip. We performed a retrospective review of patients who underwent magnetic resonance imaging (MRI) of the hip and subsequent hip arthroscopy in order to evaluate the ability of optimized, noncontrast MRI to identify tears of the acetabular labrum and defects in articular cartilage. Type of Study: Retrospective review of a consecutive sample. Methods: Between January 1997 and July 2000, 92 patients had MRI of the hip, followed by arthroscopic surgery of that hip by 1 of 2 surgeons (R.B., D.E.P.). Two musculoskeletal MR radiologists blinded to the initial MRI and surgical findings, independently interpreted the studies, looking for the location and degree of articular cartilage and acetabular labral pathology. Results: Of the 92 patients studied, each of 2 radiologists correctly identified 83 (94%) and 84 (95%) of the 88 labral tears present at surgery, respectively. There was 92% interobserver agreement on the MRI studies. For articular cartilage defects on the femoral head and acetabulum, there was good agreement (92% and 86% within 1 grade) between MRI and surgical grading and between the 2 MR readers (kappa of 0.8 for femoral head cartilage and 0.7 for acetabular cartilage). Conclusions: This study shows that noncontrast MRI of the hip, using an optimized protocol, can noninvasively identify labral and chondral pathology. Such information may facilitate deciding which patients warrant surgical intervention, thus preserving hip arthroscopy as a therapeutic tool.