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1.
G. Mathew M. Kowalczuk B. Hetaimish A. Bedi M. J. Philippon M. Bhandari N. Simunovic S. Crouch O. R. Ayeni 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):793-800
Purpose
The purpose of this study was to estimate the radiographic prevalence of CAM-type femoroacetabular impingement (FAI) in elderly patients (≥50 years) who have undergone internal fixation for femoral neck fracture.Methods
A total of 187 frog-leg lateral radiographs of elderly patients who underwent internal fixation for a femoral neck fracture were reviewed by two independent reviewers. The alpha angle, beta angle, and femoral head–neck offset ratio were calculated. The presence of two abnormal radiographic parameters was deemed to be diagnostic of radiographic CAM-type impingement.Results
Radiographic CAM-type FAI was identified in 157 out of 187 (84 %) patients who underwent internal fixation for fractures of the femoral neck. Moderate-to-good inter-observer reliability was achieved in the measurement of radiographic parameters. With reference to fracture subtypes and prevalence of radiographic features of CAM-type morphology, 97 (72 %) out of 134 patients were positive for CAM in Garden subtypes I and II, whereas 49 (85.9 %) out of 57 patients had radiographic CAM in Garden III and IV subtypes.Conclusion
There was a high prevalence of CAM-type FAI in patients that underwent surgical fixation of femoral neck fractures. This is significantly higher than the reported prevalence in non-fracture patient populations. The high prevalence of CAM morphology could be related to several factors, including age, fracture morphology, quality of reduction, type of fixation, and fracture healing.Level of evidence
IV. 相似文献2.
3.
O. R. Ayeni E. L. Belzile V. Musahl D. Naudie S. Crouch S. Sprague M. Bhandari 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):906-910
Purpose
Currently, there is a lack of high-level evidence addressing the variety of treatment options available for patients diagnosed with femoroacetabular impingement (FAI). The objective was to determine the current state of practice for FAI in Canada.Methods
A questionnaire was developed and pretested to address the current state of knowledge among orthopaedic surgeons regarding FAI treatment using a focus group of experts, reviewing prior surveys, and reviewing online guidelines addressing surgical interventions for FAI. The membership of the Canadian Orthopaedic Association (COA) was surveyed through email and mail in both French and English.Results
Two hundred and two surveys were obtained (20 % response rate), of which 74.3 % of respondents manage patients under age 40 with hip pain. Most surgeons (62 %) considered failure of non-operative management as the most important indication for the surgical management of FAI, usually by treating both bony and soft tissue damage (54.4 %). The majority of surgeons were unsure of the existence of evidence supporting the best clinical test for FAI, the use of a diagnostic intra-articular injection for diagnosis of FAI, and for non-operative management of FAI. One in four respondents supported a sham surgery (24.8 %) control arm for a trial evaluating the impact of surgical intervention on FAI.Conclusions
This survey elucidates areas of research for future studies relevant to FAI and highlights controversial areas of treatment. The results suggest that the current management of FAI by members of the COA is limited by a lack of awareness of high-level evidence.Level of evidence
III. 相似文献4.
Massimo Mariconda Andrea Cozzolino Francesco Di Pietto Manuel Ribas Vittorio Bellotti Alessandra Soldati 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):874-881
Purpose
Capoeira is a Brazilian martial art that requires extreme movements of the hip to perform jumps and kicks. This study evaluated a group of capoeira players to assess the prevalence of femoroacetabular impingement (FAI) in athletes practicing this martial art.Methods
Twenty-four experienced capoeira players (14 men, 10 women) underwent a diagnostic assessment, including clinical examination and standard radiographs of the pelvis and hips. The α-angle, head–neck offset, crossover sign, acetabular index, lateral centre-edge angle, and the Tönnis grade were assessed using the radiographs. Clinical relationships for any radiographic abnormalities indicating FAI were also evaluated.Results
Four subjects (17 %) reported pain in their hips. Forty-four hips (91.7 %) had at least one radiographic sign of CAM impingement, and 22 (45.8 %) had an α-angle of more than 60°. Eighteen hips (37.5 %) had at least one sign of pincer impingement and 16 (33.3 %) a positive crossover sign. Sixteen hips (33.3 %) had mixed impingement. There was a significant positive association between having an α-angle of more than 60° and the presence of groin pain (P = 0.002). A reduced femoral head–neck offset (P < 0.001) and an increased α-angle on the anteroposterior radiograph (P = 0.008) were independently associated with a higher Tönnis grade.Conclusion
High prevalence of radiographic CAM-type FAI among these skilled capoeira players was found. In these subjects, a negative clinical correlation for an increased α-angle was also detected. Additional caution should be exercised whenever subjects with past or present hip pain engage in capoeira.Level of evidence
Diagnostic, Level III. 相似文献5.
Michael S. Rathleff Camilla Richter Christoffer Brushøj Jesper Bencke Thomas Bandholm Per Hölmich Kristian Thorborg 《Knee surgery, sports traumatology, arthroscopy》2014,22(10):2301-2307
Purpose
To compare medial-to-lateral plantar forces during drop jump and single leg squat in individuals with and without patellofemoral pain.Methods
This cross-sectional study compared 23 young adults with patellofemoral pain to 20 age- and sex-matched controls without knee pain. The plantar pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total forefoot during drop jump. Secondary outcomes included peak medial-to-lateral force during single leg squat and mean forces during drop jump and single leg squat.Results
The primary outcome showed that individuals with patellofemoral pain had a 22 % higher medial-to-lateral peak force during drop jump, (p = 0.03). Secondary outcomes showed 32 % higher medial-to-lateral peak force during single leg squat (p = 0.01) and 19–23 % higher medial-to-lateral mean force during drop jump and single leg squat (p = 0.02–0.04).Conclusion
These findings indicate that individuals with patellofemoral pain display a more medially oriented loading pattern of the forefoot compared to individuals without knee pain. This loading pattern may be associated with the distribution of forces acting on the patellofemoral joint and suggest treatment of PFP should consider interventions that target normalisation of foot loading.Level of evidence
III. 相似文献6.
Grazia Pozzi Ezio Lanza Cleber Garcia Parra Ilaria Merli Luca Maria Sconfienza Alberto Zerbi 《La Radiologia medica》2017,122(3):208-214
Objectives:
We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome.Methods:
Hip MRA performed at our institution (3/2012–1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed.Results:
N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen.Conclusions:
GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.7.
Florian Dietrich Christian Ries Claus Eiermann Wolfgang Miehlke Christian Sobau 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):953-958
Purpose
The aim of this study was to determine whether the learning curve of arthroscopic treatment of femoroacetabular impingement (FAI) could be verified by analyzing the complication rate of this procedure. Additionally, it was investigated whether supervision by an experienced surgeon leads to a steeper learning curve (lower number of complications) when starting to perform arthroscopic FAI treatment.Methods
The complications occurring in 317 consecutive patients treated with the sole diagnosis of FAI were analyzed. 256 patients (collective A) were treated by surgeon A between June 2005 and January 2010. Sixty-one patients (collective B) were treated by surgeon B between August 2008 and December 2009. From January to June 2008, surgeon B performed many hip arthroscopies under supervision of surgeon A. Complications were recorded in a central complication register. Statistic analysis of the complication rates was performed using Fischer’s exact T test.Results
Subdividing collective A chronologically into thirds a significant decline of complications (p = 0.0044) was found with growing experience of the surgeon. Comparing the first 61 patients of both surgeons a significantly lower complication rate was discovered in the patients of surgeon B (p = 0.0375). In total there were 21 complications (6.6 %; CI 4.4–9.9 %). The observed complication rate was 7.0 % in collective A and 4.9 % in collective B.Conclusion
The learning curve can be comprehended by the distribution of complications in collective A. Having spent 6 months performing under supervision of surgeon A, surgeon B has a lower complication rate than surgeon A when comparing the first 61 patients each surgeon operated on. This implies that surgeon B benefits from the experience of surgeon A. According to this analysis, beginners in arthroscopic FAI treatment should be taught at a specialized centre to reduce the number of complications.Level of evidence
III. 相似文献8.
Marianne Lepage-Saucier Cécile Thiéry Ahmed Larbi Frédéric E. Lecouvet Bruno C. Vande Berg Patrick Omoumi 《European radiology》2014,24(7):1707-1714
Objective
To determine the means and the reference intervals of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in normal hips with high-resolution computed tomography (CT).Methods
We prospectively included 94 adult individuals who underwent CT for thoracic, abdominal or urologic pathologies. Patients with a clinical history of hip pathology and/or with osteoarthritis on CT were excluded. We calculated means and 95 % reference intervals for imaging signs of cam-type (alpha angle at 90° and 45° and femoral head–neck offset) and pincer-type impingement (acetabular version angle, lateral centre-edge angle and acetabular index).Results
The 95 % reference interval limits were all far beyond the abnormal thresholds found in the literature for cam-type and to a lesser extent for pincer-type FAI. The upper limits of the reference intervals for the alpha angles (at 90°/45°) were 68°/83° (men) and 69°/84° (women), compared to thresholds from the literature (50°, 55° or 60°). Reference intervals were similar between genders for cam-type parameters, and slightly differed for pincer-type.Conclusion
The 95 % reference intervals of morphometric measurements of FAI in asymptomatic hips were beyond the abnormal thresholds, which was especially true for cam-type FAI. Our results suggest the need for redefining the current morphometric parameters used in the diagnosis of FAI.Key Points
? 95 % reference intervals limits of FAI morphotype were beyond currently defined thresholds. ? Reference intervals of pincer-type morphotype measurements were close to current definitions. ? Reference intervals of cam-type morphotype measurements were far beyond the current definitions. ? Current morphometric definitions of cam-type morphotype should be used with care. 相似文献9.
Clinical/methodical issue
This involves high spatial resolution cardiac imaging with ultrahigh magnetic fields (7 T) and clinically acceptable image quality.Standard radiological methods
Cardiovascular magnetic resonance imaging (MRI) at a field strength of 1.5 T using a spatial resolution of (2?×?2?×?6–8) mm3.Methodical innovations
Cardiac MRI at ultrahigh field strength makes use of multitransmit/receive radiofrequency (RF) technology and development of novel technology that utilizes the traits of ultrahigh field MRI.Performance
Enhanced spatial resolution which is superior by a factor of 6–10 to what can be achieved by current clinical cardiac MRI. The relative spatial resolution (pixels per anatomical structure) comes close to what can be accomplished by current cardiac MRI in small rodents.Achievements
Feasibility studies demonstrate the gain in spatial resolution at 7.0 T due to the sensitivity advantage inherent to ultrahigh magnetic fields.Practical recommendations
Please stay tuned and please put further weight behind the solution of the remaining technical problems of cardiac MRI at 7.0 T. 相似文献10.
Elisa Amzallag-Bellenger Philippe Soyer Coralie Barbe Marie-Danièle Diebold Guillaume Cadiot Christine Hoeffel 《European radiology》2013,23(7):1901-1910
Purpose
To prospectively evaluate magnetic resonance (MR) enterography for detecting mesenteric small-bowel tumours (MSBTs) and assess the added value of gadolinium-chelate injection.Material and methods
Over a 2-year period MR enterography examinations of 75 patients (33 men, 42 women; mean age, 53.8 years; range, 19–85) with suspected MSBT were blindly analysed by two readers for the presence of MSBT. Sensitivities, specificities, predictive positive values (PPVs), negative predictive values (NPVs) and accuracies of MR enterography for the detection of MSBT were calculated on per-patient and per-lesion bases. The McNemar test was used to compare sensitivities and specificities of the unenhanced and gadolinium-enhanced sets of MR enterographies.Results
Thirty-seven MSBTs were pathologically confirmed in 26 patients. The mean tolerance score of the examinations was 0.7. On a per-patient basis, sensitivity, specificity, PPV, NPV and accuracy for detection of MSBT were 96 % [95 % CI, 89–100 %], 96 % [90–100 %], 93 % [83–100 %], 98 % [94–100 %] and 96 % [92–100 %], respectively. On a per-lesion basis, sensitivity and PPV were 70 % [56–85 %] and 93 % [83–100 %], respectively. Gadolinium injection yielded higher sensitivities on both bases (P?=?0.008).Conclusion
MR enterography is an accurate and well-tolerated imaging modality for detecting MSBT. Intravenous administration of gadolinium-chelate improves sensitivity for MSBT detection.Key Points
? MR enterography accurately detects mesenteric small bowel tumours. ? MR enterography is a well-tolerated imaging technique. ? Intravenous administration of gadolinium chelate improves sensitivity for detecting small-bowel tumours. 相似文献11.
Olufemi R. Ayeni Forough Farrokhyar Sarah Crouch Kevin Chan Sheila Sprague Mohit Bhandari 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):801-805
Purpose
Diagnostic hip injections are often used to confirm intra-articular pathology prior to arthroscopic treatment for femoroacetabular impingement (FAI). However, little is known whether the type of response correlates with the post-operative functional outcomes. The purpose of this study is to document the ability of a diagnostic hip injection to predict short-term functional outcomes following arthroscopic surgical management.Methods
A prospective cohort of 52 patients diagnosed with FAI who had an intra-articular hip injection prior to arthroscopic surgery was evaluated. A pain diary was used during the 2 weeks after hip injection to document response. In addition, the modified Harris Hip Score (mHHS) was administered preoperatively and 6 months post-operatively to assess functional outcomes. The relationship between response to an intra-articular hip injection and mHHS scores 6 months after FAI surgery was evaluated.Results
Overall, 42 of 52 (81 %) patients diagnosed with FAI achieved pain relief from the hip injection. Outcomes according to mHHS scores improved significantly at the 6-month follow-up visit (19 points, 95 % CI 15–24, p = 0.001). The therapeutic utility of the hip injection suggested that lack of pain relief predicted a lack of functional improvement following arthroscopic surgery.Conclusion
In this study, the data suggests that a positive response from an intra-articular hip injection is not a strong predictor of short-term functional outcomes following arthroscopic management of FAI. However, a negative response from an intra-articular hip injection may predict a higher likelihood of having a negative result from surgery.Level of evidence
Level II. 相似文献12.
Aaron J. Krych Timothy B. Griffith Joshua L. Hudgens Scott A. Kuzma Rafael J. Sierra Bruce A. Levy 《Knee surgery, sports traumatology, arthroscopy》2014,22(4):750-755
Purpose
Intra-articular (IA) hip cortisone injection is commonly performed as a therapeutic modality in patients with femoral acetabular impingement (FAI). To our knowledge, there is no published data evaluating the clinical benefit of these injections. The purpose of this study was to assess the efficacy of therapeutic IA cortisone injection in these patients.Methods
At our institution, patients with FAI and labral tear prospectively recorded their numerical rating scale (NRS) pain scores pre-injection, during post-injection anaesthetic phase, and at 14 days post-injection. From this cohort, all patients treated with guided IA cortisone injection, no radiographic evidence of arthritis (Tönnis grade 0 or 1) and pain relief during the anaesthetic phase of the IA injection were included. An absolute change of two points on the NRS score was considered the minimal amount of clinically significant pain relief. Pain scores were compared between the different types of steroid injected.Results
Fifty-four patients (35 females, 19 males) with a mean age of 32 ± 12 years were included. Average median pre-injection NRS score was 7.0 (range 2.5–10.0), post-injection anaesthetic phase was 1.0 (range 0.0–5.0), and 14 day post-injection was 5.0 (range 0.0–10.0). As a group, NRS scores significantly diminished from post-injection anaesthetic phase to 14 days post-injection (p < 0.001). At 14 days post-injection, only 20 patients (37 %) and at 6 weeks, only 3 patients (6 %) reported a clinically significant decrease in pain. Average duration of pain relief was 9.8 days. There was no difference in pain reduction between steroid preparations.Conclusion
In patients with symptomatic FAI and labral tear, intra-articular cortisone injection has limited clinical benefit as a therapeutic modality. However, anaesthetic-only IA injections for patients who may be candidates for hip arthroscopy can be a useful diagnostic tool.Level of evidence
Therapeutic case series, Level IV. 相似文献13.
14.
Objectives
Femoroacetabular impingement (FAI) is increasingly diagnosed clinically. Controversy exists about the significance of radiographic findings. Our goal is to determine the prevalence of radiographic FAI types and parameters in a hospital population clinically not suspected of having FAI. In addition we assessed whether pain, age and gender are associated with higher prevalences.Methods
Three hundred ten patients were included in this retrospective study. After applying the exclusion criteria, 262 patients (522 hips) remained. Two observers scored for radiographic parameters. A generalised estimation equation, Pearson’s χ2 test and logistic regression model were used.Results
Radiographic signs of FAI were absent in only 58 hips (11.1 %). In the 40 hips (7.7 %) with cam impingement, males were more affected (P?<?0.001). In the 330 hips (63.2 %) with pincer impingement, females were more often affected (P?<?0.001). In the 82 hips (15.7 %) with signs of mixed type impingement, male hips were significantly (P?<?0.001) more often affected. Age had some effect on the prevalence of coxa vara, acetabular index and acetabular retroversion. No correlation with pain was found.Conclusions
In this hospital population, signs occurred at a high rate. Radiographic parameters attributed to FAI are non-specific. Especially radiographic signs attributed to pincer type impingement have a high prevalence.Key Points
? Femoroacetabular impingement is associated with an abnormal configuration of the hip joint. ? The prevalence of femoroacetabular impingement parameters was high in our study population. ? The diagnosis of femoroacetabular impingement should be made clinically. 相似文献15.
Nicolas R.A. Newcomb Tim V. Wrigley Rana S. Hinman Jessica Kasza Libby Spiers John O’Donnell Kim L. Bennell 《Journal of Science and Medicine in Sport》2018,21(2):111-116
Objectives
This study evaluates whether hip bracing in patients with femoroacetabular impingement (FAI) (a) immediately reduces range of hip internal rotation, flexion, adduction, and pain during functional tasks; and (b) improves patient-reported outcomes when worn daily over 4 weeks.Design
Within-participant design followed by a case series.Methods
Twenty-five adults with symptomatic FAI underwent 3D kinematic assessment with and without a hip brace during single-leg squat, double-leg squat, stair ascent, and stair descent. A subset of this population (n = 17) continued to wear the brace daily for 4-weeks. A linear mixed statistical model was used to assess pain and kinematic differences between the braced and unbraced conditions at baseline testing. Patient-reported outcomes (NRS pain, iHot-33 and HAGOS questionnaires) at 4-weeks were compared to baseline using paired t-tests.Results
Bracing resulted in significant but small reductions in peak hip flexion ranging between 5.3° (95% CI 0.8°–9.7°) and 5.6° (95% CI 1.1°–10.0°), internal rotation ranging between 2.5° (95% CI 0.6°–4.4°) and 6.4° (95% CI 4.5°–8.2°), and adduction ranging between 2.2° (95% CI 0.5°–3.8°) and 3.3° (95% CI 1.6°–5.0°) during all tasks, except flexion during single-leg squat, compared with the unbraced condition; pain was not significantly improved with the brace. Bracing over four weeks did not significantly change patient-reported outcomes.Conclusions
Bracing subtly limited impinging hip movements during functional tasks, but did not immediately reduce pain or improve patient-reported clinical outcomes after 4 weeks in a young adult cohort with long-standing FAI. 相似文献16.
Olufemi R. Ayeni Douglas Naudie Sarah Crouch Anthony Adili Bharadwaj Pindiprolu Teresa Chien Paul E. Beaulé Mohit Bhandari 《Knee surgery, sports traumatology, arthroscopy》2013,21(7):1676-1683
Purpose
There is a lack of detailed information about the indications of surgical treatment for femoroacetabular impingement (FAI), particularly using open surgical dislocation. The purpose of this review was to systematically review the reported indications for surgical dislocation of the hip for FAI.Methods
Two databases (MEDLINE and EMBASE) were screened for clinical studies involving the treatment for FAI with surgical hip dislocation. We conducted a full-text review and the references for each included paper were hand-searched for other eligible studies. Papers published until September 2011 were included in this review. Two individuals reviewed all identified studies independently, and any disagreement was resolved through consensus.Results
Fifteen studies met the eligibility criteria, which included a total of 822 patients. We identified a lack of consensus for clinical and radiographic indications for surgical hip dislocation to treat FAI. The most common clinical indications reported were clinical symptoms such as hip pain in 10 papers (67 %), a positive impingement sign in 9 papers (60 %), painful/reduced range of motion in 9 papers (60 %), activity-related groin pain in 4 papers (27 %), and non-responsive to non-operative treatment in 4 papers (27 %). The most commonly reported radiographic indicators for surgical hip dislocation were a variety of impingement findings from radiographs in all 15 included papers (100 %), a combination of radiographs and MRA in 5 papers (33 %) or radiographs and MRI in 3 papers (20 %).Conclusions
These results showed that that there was an inconsistency between the clinical and radiographic indications for surgical hip dislocation as a treatment for femoroacetabular impingement. This review suggests that there is a need for the development of standardized clinical and radiological criteria that serve as guidelines for surgical treatment for FAI.Level of evidence
Systematic review, Level IV. 相似文献17.
Bruno Ferreira Marinho Bruno Follmer João Victor Del Conti Esteves Leonardo Vidal Andreato 《Sport Sciences for Health》2016,12(2):157-165
Purpose
To describe the morphofunctional characteristics of elite mixed martial arts athletes.Methods
Eight male Brazilian athletes (aged: 31 ± 5 years; training experience: 5 ± 1 years; height: 1.77 ± 0.05 m; body mass: 82.1 ± 9.6 kg) with national training experience were subjected to anthropometric evaluation to estimate body composition and somatotype, and maximal strength (1 RM) in squat and bench press, abdominal and upper limb endurance, and lower limb power were determined.Results
Body fat levels of 13.4 ± 5.6 %, lean mass levels of 69.6 ± 4.6 %, and mesomorphic component (6.4 ± 0.8) were observed. Athletes performed 42 ± 14 sit-ups and 37 ± 9 push-ups, and remained for 35 ± 10 s in the flexed-arm hang test. Athletes reached 2.19 ± 0.31 m in the horizontal jump test, and obtained absolute 1-RM values of 80 ± 15 kg and 68.5 ± 6.0 kg and relative values of 1.00 ± 0.2 kg/kg and 0.84 ± 0.10 kg/kg in bench press and squat tests, respectively.Conclusion
Results indicate body fat levels in accordance with other studies, high lean body mass, and a predominantly mesomorphic component. Abdominal and upper limb endurance were classified as excellent, while results of the flexed-arm hang test were similar to previous data. Mixed martial arts athletes’ lower limb performance in the horizontal jump was classified as weak. Lower levels of maximal strength were obtained in squat and bench press tests.18.
Tomohiro Yoneyama Ukihide Tateishi Takashi Terauchi Tomio Inoue 《Japanese journal of radiology》2014,32(3):155-163
Purpose
This study was conducted to assess the relationship between 11C-choline uptake and pathologic findings obtained by combined use of magnetic resonance (MR) and positron emission tomography (PET) imaging of patients with prostate cancer.Materials and methods
We retrospectively evaluated 69 patients with prostate cancer who underwent 11C-choline PET-CT and magnetic resonance imaging before radical prostatectomy. Combined MR–PET images were acquired to obtain precise anatomic information. The maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) were compared with pathologic findings from resected specimens as the reference standard.Results
The mean and standard deviation of tumor SUVmax and MTV were 3.9 ± 1.8 and 12.9 ± 16.4, respectively. Tumors with high MTV (≧8.2) were more likely to be admixed with prostatic intraepithelial neoplasia (PIN) (p < 0.0001) or hyperplasia (p < 0.0001) in the background than those without these findings. Multiple regression analysis also revealed that the presence of hyperplasia (OR; 4.25, 95 % CI 1.25–14.4, p = 0.02) and PIN (OR; 9.22, 95 % CI 2.60–32.7, p = 0.001) were associated with tumors with high MTV.Conclusion
We have demonstrated, by pathologic evaluation of patients with prostate cancer, that 11C-choline uptake volume is greater for prostate cancer admixed with PIN and hyperplasia than that without. 相似文献19.
Aman Khurana Christina A. Eisenhut Wenshuai Wan Katayoon B. Ebrahimi Chirag Patel Joan M. O’Brien Kristen Yeom Heike E. Daldrup-Link 《European radiology》2013,23(5):1271-1280
Purpose
To compare the diagnostic value of magnetic resonance (MR) imaging and ophthalmoscopy for staging of retinoblastoma.Methods
MR and ophthalmoscopic images of 36 patients who underwent enucleation were evaluated retrospectively following institutional review board approval. Histopathology being the standard of reference, the sensitivity and specificity of both diagnostic modalities were compared regarding growth pattern, iris neoangiogenesis, retinal detachment, vitreous seeds and optic nerve invasion. Data were analysed via McNemar’s test.Results
Both investigations showed no significant difference in accuracy for the detection of different tumour growth patterns (P?=?0.80). Vitreous seeding detection was superior by ophthalmoscopy (P?<?0.001). For prelaminar optic nerve invasion, MR imaging showed similar sensitivity as ophthalmoscopy but increased specificity of 40 % (CI 0.12–0.74) vs. 20 % (0.03–0.56). MR detected optic nerve involvement past the lamina cribrosa with a sensitivity of 80 % (0.28–0.99) and a specificity of 74 % (0.55–0.88). The absence of optic nerve enhancement excluded histopathological infiltration, but the presence of optic nerve enhancement included a high number of false positives (22–24 %).Conclusions
Ophthalmoscopy remains the method of choice for determining extent within the globe while MR imaging is useful for evaluating extraocular tumour extension. Thus, both have their own strengths and contribute uniquely to the staging of retinoblastoma.Key Points
? Ophthalmoscopy: method of choice for determining extent of retinoblastoma within the globe. ? MR imaging provides optimal evaluation of extrascleral and extraocular tumour extension. ? Positive enhancement of the optic nerve on MRI does not necessarily indicate involvement. 相似文献20.
F. Cornelis F. Petitpierre A. S. Lasserre E. Tricaud B. Dallaudière E. Stoeckle Y. Le Bras M. Bouzgarrou J. L. Brun N. Grenier 《Cardiovascular and interventional radiology》2014,37(6):1575-1579