多模态影像学对股骨髋臼撞击综合征临床诊断价值的研究  

value of multimodal imaging in the clinical diagnosis of femoral acetabular impingement syndrome

作　　者：郭晓霖 刘晓飞 田春梅[1] 董立杰 陈亮[1] 丁孝民 张林[1] GUO Xiao-lin;LIU Xiao-fei;TIAN Chun-mei;DONG Li-jie;CHEN Liang;DING Xiao-min;ZHANG Lin(Department of Radiology,Binzhou Medical University Hospital,Binzhou Shandong 256603,China;Micro Intervention Center,Dezhou Hospital,Qilu Hospital of Shandong University,Dezhou Shandong 253000,China)

机构地区：[1]滨州医学院附属医院放射科,山东滨州256603 [2]山东大学齐鲁医院德州医院微创介入中心,山东德州253000

出　　处：《中国临床医学影像杂志》2024年第10期737-740,共4页Journal of China Clinic Medical Imaging

基　　金：滨州医学院研究生教学案例库建设项目基金资助项目。

摘　　要：目的:探讨多模态影像学对股骨髋臼撞击综合征(FAIS)的诊断应用价值。方法:选取经关节镜手术证实的53例FAIS患者作为病例组,40例无髋关节异常患者作为对照组;两组均行X线、CT平扫+三维重建、MRI平扫检查。比较各检查方法异常征象阳性率的差异性;并分别计算其诊断FAIS的敏感性、特异性、准确率、阳性预测值、阴性预测值,构建各检查方法的受试者工作特性曲线,并计算其曲线下面积(AUC)。结果:X线、CT检查下,CT对股骨头颈交界处骨赘和/或异常凸起征象的阳性检出率最高(71.70%)。MRI检查下,对髋臼盂唇信号或形态异常的阳性检出率最高(73.58%)。MRI(AUC=0.944)的诊断效能高于CT(AUC=0.890)和X线(AUC=0.834),CT诊断效能高于X线。结论:多模态影像学检查对FAIS的诊断价值高于单一检查方法,可以为临床诊断及治疗提供可靠、客观的依据。Objective:To evaluate the value of multimodal imaging in the diagnosis of femoral acetabular impingement syndrome(FAIS).Methods:A total of 53 patients with FAIS confirmed by arthroscopic surgery were selected as the case group and 40 patients without abnormal hip joint were selected as the control group.X-ray,CT plain scan+3D reconstruction,MRI plain scan were performed in both groups.The difference of positive rate of abnormal signs was compared.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the diagnosis FAIS were calculated,and the receiver operating characteristic curve of each test was constructed,and the area under the curve(AUC)was calculated.Results:Under X-ray and CT examination,CT had the highest positive detection rate(71.70%)for osteophytes and/or abnormal protrusions at the junction of head and neck of femur.MRI showed the highest positive detection rate(73.58%)for labial signal or morphological abnormality of acetabulum.The diagnostic efficacy of MRI(AUC=0.944)was higher than that of CT(AUC=0.890)and X-ray(AUC=0.834),and the diagnostic efficacy of CT was higher than that of X-ray.Conclusion:The diagnostic value of MMI examination for FAIS is higher than that of a single examination method,which can provide a reliable and objective basis for clinical diagnosis and treatment.

关 键 词：股骨髋臼撞击征 放射摄影术 体层摄影术 X线计算机 磁共振成像 

分 类 号：R684[医药卫生—骨科学] R814.41[医药卫生—外科学] R814.42[医药卫生—临床医学] R445.2