股骨颈疝窝与股骨髋臼撞击综合征相关解剖学异常的多层螺旋CT研究  

Correlation between the prevalence of herniation pits of femoral neck and anatomical parameters related to femoroacetabular impingement： multislice CT study

作　　者：黄耀渠[1] 李均洪[2] 梁振华[2] 陈卫国[3] 

机构地区：[1]广东省佛山市中医院MRI室,528000 [2]广东省佛山市中医院CT室 [3]南方医科大学南方医院放射科

出　　处：《中华解剖与临床杂志》2016年第1期18-21,共4页Chinese Journal of Anatomy and Clinics

摘　　要：目的 探讨股骨颈疝窝与股骨髋臼撞击综合征（FAI）相关解剖学参数或结构异常之间的关系。方法回顾性分析2013年6月～2014年12月佛山市中医院CT室352例无髋关节症状行MSCT检查，扫描范罔包括髋关节的患者的MSCT资料，其中诊断股骨颈疝窝且髋关节存在疝窝者（观察组）63例79髋（双侧16例，单侧47例），诊断股骨颈疝窝但髋关节不存在疝窝者（对照组）47例47髋，在余下的242例患者中按性别、年龄匹配63例非股骨颈疝窝且双侧髋关节均无疝窝患者为阴性对照组。测量各髋关节的股骨颈仅角、股骨头颈偏距率、股骨头直径、股骨头颈交界部宽径、股骨颈七部宽径、髋臼前倾角、前髋臼角、后髋臼角及髋闷凹陷指数等参数。采用方差分析比较3组间各参数的差异。结果观察组和对照组髋关节的各解剖学参数差异均无统纠一学意义（P值均〉0．05）。观察组和对照组头颈交界部宽度、股骨颈上部宽度及股骨颈d角均大于阴性对照组，股骨头颈偏距率则小于阴性对照组，差异均有统计学意义（P值均〈0．05）。3组患者的股骨头直径、髋臼的倾角、前髋臼角、后髋臼角及髋臼凹陷指数差异均尢统计学意义（P值均〉0．05）。结论股骨颈疝窝患者存在股骨近端的形态异常，可能与Cam型FAI相关。Objective To investigate the correlation between the presence of herniation pits and anatomical parameters related to femoroacetabular impingement （FAI） based on muhislice computed tomography. Methods From June 2013 to December 2014, 352 consecutive patients underwent 64-slice CT scan in CT Room of Foshan Hospital of Traditional Chinese Medicine for symptom of abdomen or pelvis that included the hip in the scan range were collected. Seventy-nine herniation pits were observed in sixty-three patients, and the hip joints were divided into the observation group and the control group according to with or without herniation pits. Sixty-three patients with matched sex and age but without pits were randomly selected as negative control group. The alpha angles, head-neck offset ratio, width of femoral head-neck junction and upper femoral neck, aeetabular anteversion angle, anterior and posterior acetabublar sector angle, and hip index of hips were measured. The difference of morphological indicators among these three groups was statistically analysed by one-way ANOVA. Results The anatomical parameters of proximal femur and acetabulum of the observation group and the control group had no statistically significant difference （all P values 〉0. 05）. The width of femoral head-neck junction and upper femoral neck, and alpha angles of the observation group and the control group were greater than those in the negative control group（ all P values 〈 0.05 ）. The head-neck offset ratio of the observation group and the control group was smaller than those in the negative control group （ all P values 〈 0. 05 ）. The difference of diameter of femoral head, and acetabublar anatomical parameters （ acetabular anteversion angle, anterior and posterior acetabublar sector angle, and hip index） among three groups had no significant difference（ all P values 〉 0.05 ）. Conclusions Herniation pits are associated with Cam-type FAI abnormalities of proximal femur.

关 键 词：股骨髋臼撞击征 股骨颈疝窝 体层摄影术 螺旋计算机 解剖学 

分 类 号：R684[医药卫生—骨科学] R816.8[医药卫生—外科学]