外旋位-坐骨股骨撞击综合征的磁共振成像诊断  

External rotation-MRI diagnosis of ischiofemoral impingement syndrome

作　　者：张俊丽[1] 余留森[1] 祝丽敏[1] 

机构地区：[1]河南省安阳地区医院影像科,濮阳455000

出　　处：《实用医学影像杂志》2017年第6期495-497,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨下肢处于外旋位时坐骨股骨撞击综合征(IFI)的磁共振成像(MRI)诊断。方法回顾性分析2016年1月至2017年6月,行髋关节MRI检查58例患者(108个髋关节)的资料;其中将临床及MRI共同诊断为IFI的21例患者(34个髋关节)作为病例组;髋关节MRI表现正常的37例患者(74个髋关节)作为对照组;测量两组坐骨股骨间隙(IFS)、股方肌间隙(QFS)和股骨颈干角(CCD),比较两组上述测量指标的差异;同时分析IFI患者MRI图像特点。结果病例组患者的IFS和QFS分别为(10.5±3.5)mm和(7.4±2.7)mm,均明显小于对照组分别为(23.4±5.1)mm(t=-14.670,P<0.01)、15.6±4.7 mm(t=-11.061,P<0.01),两组间IFS和QFS差异有统计学意义;病例组和对照组的CCD分别为(132±5)°和(129±5)°,两组间CCD差异有统计学意义(P<0.05);病例组中21例为股方肌卡压伴水肿(轻度水肿占76%,中度水肿占15%,重度水肿占9%),4例为股方肌卡压伴部分撕裂,2例为股方肌卡压伴局限性脂肪浸润(中度脂肪化1例、重度脂肪化1例),2例为髂腰肌肌腱水肿,1例为绳肌肌腱病,2例为股骨小转子过长。结论无论下肢处于内旋、外旋还是中立位,IFI患者的IFS和QFS均明显变窄,股方肌出现卡压变形伴水肿和(或)撕裂是IFI常见的MRI表现。Objective To investigate the manifestation of MRI in the diagnosis of ischiofemoral impingemen （I-FI） syndrome. Methods The data of 58 patients （108 hips） from 2016 January to 2017 June who were performed hip MRI examination was analyzed retrospectively. 21 patients （34 hips） with clinical and MRI diagnosis of IFI syndrome were selected as case group, while the other 37 patients （74 hips） with normal manifestation of hip MRI were selected as control group. Their ischiofemoral space （IFS）^quadratus femoris space （QFS） and cervicodiaphyseal angle （CCD） were measured respectively. Comparing the differences of aforementioned data in the two groups. MRI image features of IFI patients were analyzed. Results IFS and QFS in case group were 10.5±3.5 mm and 7.4±2.7 mm, and that in control group were 23.4±5.1 mm and 15.6±4.7 mm, respectively , the differences between two groups were with statis-tical significance 14.670,-11.061, P〈0.01）. CCD in case group and in control group were （132.4±5.2）° and （129.3±5.1）0. CCD showed significant difference between the two groups（P〈0.05）. 21 cases of the case group showed quadratus femoris compression with edema, mild edema（76%）, moderate edema（15%）, severe edema（9%）. 4 cases showed quadratus femoris muscle compression with partial tear, moderate fatty replacement （1 case）, severe fatty re-placement （1 case）. 2 cases showed iliopsoas muscle tendon edema. 1 case showed hamstring tendon disease. 2 cases of femoral small rotor is too long. Conclussion Regardless of the low extremities in internal rotation and external ro-tation or neutral position, IFS and QFS of IFI patients were significantly narrowed. Quadratus femoris muscle shows compressive deformation with edema and （or） tear is common manifestation of MRI in IFI patients.

关 键 词：磁共振成像 坐骨 股骨 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.8[医药卫生—诊断学]