质子密度加权成像对髋臼盂唇撕裂的评估价值

周荣花; 张海龙; 程晓光; 梁伟; 蒋雯

doi:10.16766/j.cnki.issn.1674-4152.002865

质子密度加权成像对髋臼盂唇撕裂的评估价值

doi: 10.16766/j.cnki.issn.1674-4152.002865

1.
北京积水潭医院放射科，北京 100035
2.
北京积水潭医院运动医学科

基金项目:

北京市医院管理中心临床医学发展专项项目 ZYLX202107

详细信息

通讯作者:
蒋雯，E-mail：soundofring@hotmail.com

中图分类号: R445.2 R684
计量
- 文章访问数: 200
- HTML全文浏览量: 61
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-06
- 网络出版日期: 2023-04-20

Value of proton density weighted image in evaluating acetabular labrum tears

1.
Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China

摘要

摘要: 目的研究质子密度加权成像(PD-WI)对髋臼盂唇撕裂的评估是否可靠。方法选取于2019年3月—2020年1月在北京积水潭医院就诊，无明显外伤或轻微外伤后髋关节疼痛的40名患者，男女各20例，年龄为27~65岁，平均年龄为40岁，进行包含PD-WI序列的髋臼盂唇磁共振扫描，排除髋部骨折、肿瘤或感染等因素。在不清楚手术结果的情况下根据PD-WI图像评估髋臼盂唇撕裂的存在，并根据以往组织学的研究通过PD-WI图像将髋臼盂唇撕裂分为盂唇基底部和实质部撕裂2种类型。全部患者在扫描结束后3个月内均接受手术治疗。根据手术结果获取PD-WI评估髋臼盂唇撕裂的敏感度、特异度和准确度，并使用Kappa检验评价髋臼盂唇撕裂和撕裂分型的PD-WI诊断意见与手术结果的一致性。结果 PD-WI评估髋臼前/外上盂唇撕裂的灵敏度分别为96.88%和90.00%，特异度分别为62.50%和93.33%，准确度分别为90.00%和92.50%，髋臼盂唇撕裂和撕裂分型的PD-WI诊断意见与手术结果的一致性较好或很好(前盂唇撕裂Kappa=0.655，外上盂唇撕裂Kappa=0.806，均P < 0.001；各型撕裂Kappa值均>0.75，均P < 0.001)。结论 PD-WI能够作为可靠的评估髋臼盂唇撕裂的影像学方法，为患者的诊断和治疗方案的选择提供帮助。
- 髋臼盂唇 /
- 磁共振 /
- 质子密度加权成像 /
- 盂唇撕裂
Abstract: Objective To explore the reliability of proton density weighted image (PD-WI) in evaluating acetabular labrum tears. Methods Forty trauma hip pain out-patients (20 males and 20 females, age range: 27-65 years, mean age: 40 years) without obvious or slight trauma in Beijing Jishuitan Hospital from March 2019 to January 2020 were recruited and underwent acetabular labral magnetic resonance imaging scan that included PD-WI sequence to exclude acetabular labrum tears and exclude fracture, tumour, infection and other diseases in hip. The presence of acetabular labrum tear was evaluated according to PD-WI image instead of surgical outcome. Classification consisting of basal and substantial tears from previous histological studies was also determined by PD-WI image. All patients underwent surgery in 3 months after scanning. According to surgical outcome, the sensitivity, specificity and accuracy of PD-WI to evaluate acetabular labrum tears and kappa consistency test to evaluate tears and classification were acquired. Results The sensitivity, specificity and accuracy of PD-WI to evaluate anterior and lateral-superior acetabular labrum tears were 96.88% and 90.00%, 62.50% and 93.33%, 90.00% and 92.50%, respectively. The PD-WI diagnosis of acetabular labial tears and tear classification was in good agreement with the surgical results (anterior labrum tears: Kappa=0.655, P < 0.001; lateral-superior labrum tears: Kappa=0.806, P < 0.001; all types of tear: Kappa>0.75, P < 0.0001). Conclusion PD-WI could be regarded as a reliable imaging method to evaluate acetabular labrum tears and could be helpful for diagnosis and treatment option.
- Acetabular labrum /
- Magnetic resonance imaging /
- Proton density weighted image /
- Labral tears

HTML全文

图 1 髋臼盂唇磁共振扫描的定位方法

注：A为髋关节冠状位T2压脂序列的定位图；B为髋关节轴位质子密度加权序列的定位图；C为髋臼盂唇斜冠状位质子密度加权压脂序列的定位图；D为髋臼盂唇斜矢状位质子密度加权压脂序列的定位图。

Figure 1. Positioning method of acetabular labial magnetic resonance scanning

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图 2 正常髋臼盂唇质子密度加权压脂图像

注：女性患者，35岁，左侧髋关节；A为斜矢状位显示髋臼前盂唇和后盂唇；B为斜冠状位显示髋臼外上盂唇。正常盂唇均呈宽基底三角形样，边缘锐利，在质子密度加权压脂图像呈均匀低信号。

Figure 2. Image of normal acetabular labrum with proton density weighted lipids

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图 3 髋臼前盂唇基底部撕裂质子密度加权压脂图与关节镜下所见

注：女性患者，29岁，右侧髋关节；A为斜矢状位质子密度加权压脂图像显示髋臼前盂唇基底部见线样高信号，累及关节面侧(箭头)；B为关节镜下显示髋臼前盂唇基底部与关节软骨移行区部分分离(箭头)。

Figure 3. Image of tear at the base of the anterior labrum of the acetabulum with proton density weighted lipids and arthroscopy

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图 4 髋臼前盂唇实质部撕裂质子密度加权压脂图与关节镜下所见

注：男性患者，54岁，左侧髋关节；A为斜矢状位质子密度加权压脂图像显示髋臼前盂唇形态不整，实质部见不均匀高信号(箭头)；B为关节镜下显示髋臼前盂唇实质部撕裂(箭头)。

Figure 4. Image of parenchymal tear of the anterior labrum of the acetabulum with proton density weighted lipids and arthroscopy

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表 1 髋臼盂唇MRI扫描的序列及参数

Table 1. Sequence and parameters of MRI scanning of acetabular labrum

序列	TE(ms)	TR(ms)	层厚(mm)	层间距(mm)	层数	视野(mm²)	矩阵
冠状位T2压脂序列	60	3 943	4	0.4	20	300×388	308×305
轴位质子密度加权序列	30	3 000	3	0.3	20	200×336	332×452
斜冠状位质子密度加权压脂序列	40	3 600	3	0.3	24	160×160	352×188
斜矢状位质子密度加权压脂序列	40	3 200	3	0.3	23	160×160	292×283

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表 2 髋臼前盂唇撕裂的MRI结果与手术结果的对比(例)

Table 2. Comparison of MRI and surgical results of anterior labrum tear of acetabulum (cases)

MRI诊断	前盂唇撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	31	3
MRI阴性	1	5
注：Kappa=0.655，P < 0.001。

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表 3 髋臼外上盂唇撕裂的MRI结果与手术结果的对比(例)

Table 3. Comparison of MRI results and surgical results of external acetabular superior labrum tear (cases)

MRI诊断	外上盂唇撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	9	2
MRI阴性	1	28
注：Kappa=0.806，P < 0.001。

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表 4 髋臼前盂唇Ⅰ型撕裂的MRI结果与手术结果的对比(例)

Table 4. Comparison of MRI and surgical results for Type Ⅰ anterior labrum tear of acetabulum (cases)

MRI诊断	前盂唇Ⅰ型撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	17	3
MRI阴性	1	19
注：Kappa=0.800，P < 0.001。

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表 5 髋臼前盂唇Ⅱ型撕裂的MRI结果与手术结果的对比(例)

Table 5. Comparison of MRI and surgical results for Type Ⅱ anterior labrum tear of acetabulum (cases)

MRI诊断	前盂唇Ⅱ型撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	14	0
MRI阴性	0	26
注：Kappa=1.000，P < 0.001。

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表 6 髋臼外上盂唇Ⅰ型撕裂的MRI结果与手术结果的对比(例)

Table 6. Comparison of MRI results and surgical results of Type Ⅰ external acetabular superior labrum tear

MRI诊断	外上盂唇Ⅰ型撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	5	2
MRI阴性	0	33
注：Kappa=0.805，P < 0.001。

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表 7 髋臼外上盂唇Ⅱ型撕裂的MRI结果与手术结果的对比(例)

Table 7. Comparison of MRI results and surgical results of Type Ⅱ external acetabular superior labrum tear

MRI诊断	外上盂唇Ⅱ型撕裂
MRI诊断	手术阳性	手术阴性
MRI阳性	4	0
MRI阴性	1	35
注：Kappa=0.875，P < 0.001。

下载: 导出CSV

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