3.0T常规MRI与MR髋关节造影诊断髋臼唇撕裂的对比研究

目的 在3.0 T场强中,比较常规髋关节MRI及MR髋关节造影对髋臼唇撕裂的诊断价值.方法 回顾分析44例髋关节病变患者的患侧髋关节常规MRI及MR髋关节造影资料,将每例患者的臼唇划分为前、上、后3处区域(共计132处),确定有无撕裂,并进行分型.其中5例患者经髋关节镜检查.对于常规MRI及MR髋关节造影获得的臼唇撕裂及分型数据差异比较采用Wilcoxon秩和检验,一致性比较采用Kappa检验.结果 常规MRI与MR髋关节造影诊断完全相同者计116处臼唇,只有16处存在诊断差异.其中,前者诊断无撕裂而后者诊断撕裂者9处,前者诊断撕裂但后者诊断无撕裂者6处,其余1处两者均诊断为撕裂但分型不同.常规MRI与MR髋关节造影的评价差异没有统计学意义(Z=0.347,P＞0.05),且具有极好的一致性(K=0.781,P＜0.01).在接受关节镜的5例患者中,常规MRI、MR髋关节造影及关节镜结果均完全吻合.结论 对髋臼唇撕裂,3.0 T常规髋关节MRI可获得与MR髋关节造影基本相同的诊断效果.

3.0 T conventional MRI and MR arthrography in the evaluation of acetabular labral tears

Objective To compare the diagnostic value of conventional MR imaging with MR arthrography for acetabular labral tears at 3.0 T MR imaging Methods Forty-four patients suspected of acetabular labral pathology were prospectively scanned with conventional MR imaging and MR arthrography of the affected hip joints. All MR data were retrospectively studied. Each acetabular labrum was divided into three regions of anterior, superior, and posterior, and the acetabular tear and its classification were recorded. Five patients underwent subsequent hip arthroscopy. Wilcoxon signed ranks test was used to compare the difference between MR imaging and MR arthrography, and Kappa value was adopted for the evaluation of agreement of these two techniques. Results One hundred and sixteen regions of acetabular labrum were evaluated to be concordant at MR imaging and MR arthrography. Only 16 regions had different results at MR imaging and MR arthrography, in which 9 were diagnosed to have tears at MR arthrography but non-tear at MR imaging, and 6 had tears at MR imaging but non-tear at MR arthrography, and the other one had tears at both exams but of different classifications. In 5 patients confirmed by hip arthroscopy, both the evaluations of MR imaging and MR arthrography were accordant with that of arthroscopy. There were no statistical difference between MR imaging and MR arthrography ( Z = 0. 347, P ＞ 0. 05 ) for diagnosing the acetabular labral tears, and good agreements (Kappa = 0. 781 ,P ＜ 0. 01 ) were found between these two methods. Conclusion Conventional MR imaging of hip joints at 3.0 T shows similar diagnostic value with MR arthrography in evaluating the acetabular labral tears.