MR关节造影在10~18岁髋关节盂唇损伤的位置和分型中的诊断价值  

Diagnostic value of MR arthrography in location and classification of hip pelvis and labrum injury in 10 to 18 years

作　　者：李耀辉 曹毅[3] 万业达[3] LI Yaohui;CAO Yi;WAN Yeda(Graduate School of Tianjin Medical University,Tianjin 300070,China;Department of Radiology Diagnosis,No.983 Hospital,Joint Logistics Support Force of PLA,Tianjin 300142,China;Department of Radiology 1,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医科大学研究生院,天津300070 [2]中国人民解放军联勤保障部队第九八三医院放射诊断科,天津300142 [3]天津市天津医院放射科一科,天津300211

出　　处：《实用放射学杂志》2023年第7期1138-1142,共5页Journal of Practical Radiology

基　　金：天津市卫生健康委员会科技人才培育项目(KJ20050)。

摘　　要：目的 探讨磁共振关节造影(MRA)在10~18岁髋关节盂唇损伤的位置和分型中的诊断价值.方法 选取81例髋关节功能障碍患者,根据关节镜手术结果将患者分为盂唇损伤组(n=72)和未损伤组(n=9).所有患者行常规MRI检查及超声引导下髋关节MRA检查,由2名影像科医师对患者前盂唇、外上盂唇和后盂唇仔细观察,评估盂唇损伤程度,应用受试者工作特征(ROC)曲线评估MRI常规扫描和MRA对髋臼盂唇损伤的诊断效能.结果 关节镜结果显示,前盂唇、外上盂唇和后盂唇分别为67例、31例和1例;常规MRI显示前盂唇阳性51例,外上盂唇阳性19例,后盂唇阳性2例;MRA显示前盂唇阳性63例,外上盂唇阳性26例,后盂唇阳性1例.ROC曲线结果显示,MRA在前盂唇、外上盂唇敏感度和准确度明显高于常规MRI(P<0.05).对髋臼盂唇损伤的诊断效能上,MRA的敏感度(X^(2)=15.715,P<0.001)和准确度(X^(2)=17.478,P<0.001)明显高于常规MRI.根据关节镜分型标准,MRA的符合率明显高于常规MRI(X^(2)=11.000,P=0.001).结论 与常规MRI相比,MRA可显著提高10~18岁髋臼盂唇损伤的诊断效能,可有效分辨髋臼盂唇损伤位置和分型,为临床制订方案提供依据和指导.Objective To explore the diagnostic value of magnetic resonance arthrography(MRA)in location and classification of hip pelvis and labrum injury in 10 to 18 years.Methods A total of 81 children with hip dysfunction were selected.According to arthroscopy results,the children were divided into the injury group(n=72)and the non-injury group(n=9).Conventional MRI and ultrasound-guided MRA of the hip joint were performed for all the children.The anterior,lateral-superior and posterior labrum of the children were carefully observed by two imaging physicians to evaluate the labrum injury degree.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of conventional MRI scanning and MRA for acetabular labrum tear.Results Arthroscopy results showed that there were 67 cases of anterior labrum,31 cases of lateral-superior labrum and 1 case of posterior labrum,respectively;Conventional MRI showed 51 positive cases of anterior labrum,19 positive cases of lateral-superior labrum and 2 positive cases of posterior labrum;MRA showed 63 positive cases of anterior labrum,26 positive cases of lateral-superior labrum and 1 positive case of posterior labrum.The results of ROC curve showed that the sensitivity and accuracy of MRA in anterior labrum and lateralsuperior labrum were significantly higher than that of conventional MRI(P<0.05).The sensitivity of MRA in the diagnostic efficacy(X^(2)=15.715,P<0.001)and accuracy(X^(2)=17.478,P<0.001)of acetabular labrum tear was significantly higher than that of conventional MRI.According to arthroscopy classification criteria,the coincidence rate of MRA was significantly higher than that of conventional MRI(X^(2)=11.000,P=0.001).Conclusion Compared with conventional MRI,MRA can significantly improve the diagnostic efficiency of acetabular labrum tear in 10 to 18 years,which can effectively distinguish the location and classification of acetabular labrum tear,providing basis and guidance for clinical targeted programs.

关 键 词：髋臼盂唇损伤 磁共振关节造影 诊断价值 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]