1.5T常规MRI与MR髋关节造影诊断髋臼唇撕裂的比较研究

Evaluation of acetabular labral tears with conventional MR imaging versus with MR arthrography

关键词:  髋关节  髋臼  磁共振成像  关节造影术

Key words:  hip joint  acetabulum  magnetic resonance imaging  arthrography

摘要:

目的 探讨1.5T场强下常规髋关节MRI与MR髋关节造影对髋臼唇撕裂的诊断价值的差异。方法回顾性分析37例有髋关节疼痛病史患者(共55个髋关节)的1.5T常规MRI及MR髋关节造影的影像学资料,观察有无撕裂、确定撕裂部位并进行分期。其中有13例(共16个髋关节)进一步行髋关节镜检查并进行修复术。对常规MRI和MR髋关节造影诊断的髋臼唇撕裂及分期数据的差异行Wilcoxon秩和检验。结果 常规MRI与MR髋关节造影诊断相同的共计15个髋臼唇,存在差异的为40个。其中常规MRI诊断为无撕裂而MR髋关节造影诊断为有撕裂的有35个,5个常规MRI及MR髋关节造影均诊断为髋臼唇撕裂,但分期不同。行髋关节镜检查的13例16个髋关节,均发现存在髋臼唇的撕裂,其中常规MRI定位及分期正确的有4个,MR髋关节定位及分期正确的有15个。1.5T常规MRI与MR髋关节造影对髋臼唇撕裂的评价差异有统计学意义(Z=0.560,P<0.01)。结论 1.5T场强下,MR髋关节造影对髋臼唇撕裂的诊断价值优于常规MRI检查。

Abstract:

Objective To compare MR arthrography with conventional MR imaging in evaluation of acetabular labral tears. Methods Fifty-five hips of 37 patients with hip pain were examined with 1.5T conventional MR imaging and MR arthrography. The findings of conventional MRI and MR arthrograms were retrospectively reviewed in terms of the presence, position and staging of acetabular labral tears. Sixteen hips of 13 patients underwent subsequent hip arthroscopic examination and repairing. Wilcoxon rank sum test was used to compare conventional MR imagine and MR arthrography in diagnosis of the presence and staging of acetabular labral tears. ResultsThe consistent diagnosis of conventional MR imagines and MR arthrograms in 15 hips and inconsistency of two methods in 40 hips were found. In 35 hips, acetabular labral tear was found on MR arthrograms but not detected on conventional MR images. In 5 hips, acetabular labral tears were demonstrated on both conventional MR images and MR arthrograms but with different stages. In 16 hips of 13 patients underwent subsequent hip arthroscopy, tears were detected in all hips. Four of the 16 labra were staged accurately with conventional MR imaging. On MR arthrograms, 15 of the 16 labral tears were staged correctly. There was significant difference between conventional MRI imagine and MR arthrography in diagnosis of acetabular labral tear (Z=0.560, P<0.01). Conclusion The diagnostic value of MR arthrography is superior to MR imaging for acetabular labral tears of hip joint.