双侧股骨头缺血坏死患者双侧髋关节坐骨股骨撞击综合征发生率的MRI分析  

MRI study on the incidence of ischiofemoral impingement syndrome in patients with bilateral femoral head ischemic necrosis

作　　者：张欲翔 张泽坤 桑辉[1] 王勇[1] 沈向楠 李电成[1] 宋彦芳 ZHANG Yuxiang;ZHANG Zekun;SANG Hui;WANG Yong;SHEN Xiangnan;LI Diancheng;SONG Yanfang(Department of Radiology,TCM Hospital of Hebei Province,Shijiazhuang 050011,China;The Second Department of Orthopedics,TCM Hospital of Hebei Province,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院放射科,河北石家庄050011 [2]河北省中医院骨伤二科,河北石家庄050011

出　　处：《医学影像学杂志》2024年第10期125-128,共4页Journal of Medical Imaging

摘　　要：目的探讨MRI诊断双侧股骨头缺血坏死(ONFH)患者双侧坐骨股骨间隙(IFS)、股方肌间隙(QFS)的变化情况,以及发生坐骨股骨撞击综合征(IFI)的可能性。方法选取双侧股骨头缺血坏死程度不一致患者60例、双侧股骨头缺血坏死程度一致患者40例、健康志愿者25例(对照组)的髋关节MR图像,采用横轴位T1WI测量所有髋关节的坐骨股骨间隙(IFS)、股方肌间隙(QFS),结合临床症状及体征判断是否发生IFI,应用Kruskal-Wallis one-way test检验检测对照组、双侧股骨头缺血坏死程度一致组及不一致组组间髋关节IFS、QFS的差别,应用卡方检验检测双侧股骨头缺血坏死程度一致组、不一致组组内双侧髋关节IFI发生率的差别。结果双侧股骨头缺血坏死程度不一致组内IFS坏死程度较轻侧(20.85±6.22)mm、较重侧(24.13±6.61)mm,QFS坏死程度较轻侧(15.71±6.17)mm、较重侧(18.52±6.41)mm;双侧股骨头缺血坏死程度一致组内IFS左侧(24.83±7.57)mm、右侧(25.26±7.20)mm,QFS左侧(19.23±6.95)mm、右侧(19.18±6.79)mm;对照组内IFS(26.36±7.35)mm、QFS(19.79±5.87)mm。双侧股骨头坏死程度一致组的双侧IFS、QFS与对照组均差异无统计学意义(P>0.05),双侧股骨头坏死程度不一致组内坏死程度较轻侧IFS及QFS小于坏死程度较重侧及对照组,差异有统计学意义(P<0.05)。双侧股骨头坏死程度一致组内双侧髋关节IFI发生率差异无统计学意义(P>0.05),双侧股骨头坏死程度不一致组内坏死程度较轻侧IFI的发生率(20.0%)高于坏死程度较重侧(6.7%),差异有统计学意义(P<0.05)。结论双侧股骨头缺血坏死程度一致患者的双侧髋关节IFI的发生率无差别,双侧股骨头缺血坏死程度不一致组内坏死程度较轻侧髋关节IFI的发生率较高。Objective To investigate the change of ischiofemoral space(IFS)and quadratusfemoris space(QFS)and the possibility of ischiofemoral impingement syndrome(IFI)in patients with bilateral osteonecrosis of the femoral head(ONFH).Methods The MR images of 40 ONFH patients with bilateral same degree and 60 patients with bilateral different degree(experimental group)and 25 voulanters(control group)were retrospectively analyzed.The IFS and QFS of all hip joints were measured on the transverse T1WI;Combining clinical symptoms and signs,IFI was determined.The difference of IFS,QFS between control group,bilateral same degree ONFH and bilateral different degree ONFH were compared by Kruskal-Wallis one-way test;The incidence of IFI in bilateral hip joints was compared with chi-square test in experimental group.Results For bilateral ONFH patients with inconsistent degree of necrosis,IFS on the milder necrosis side was(20.85±6.22)mm and that on the severe side was(24.13±6.61)mm,while,QFS on the milder side was(15.71±6.17)mm and that on the severe side was(18.52±6.41)mm.For bilateral ONFH patients with consistent degree of necrosis,IFS on the left was(24.83±7.57)mm and that on the right was(25.26±7.20)mm,while,QFS on the left was(19.23±6.95)mm and that on the right was(19.18±6.79)mm.As for the control group,IFS was(26.36±7.35)mm and QFS was(19.79±5.87)mm.There was no statistically significant difference in bilateral IFS and QFS between the group with consistent degree of femoral head necrosis and the normal control group(P>0.05).For 60 patients with the bilateral different degree necrosis,IFS and QFS of less necrotic joints were smaller than those of severer ones and those of control group(P<0.05);For 40 patients with bilateral same degree necrosis,the incidence of IFI between bilateral joints were not statistical differences(P>0.05);For 60 patients with the bilateral different degree necrosis,the incidence of IFI with less necrotic hip joint(20.0%)was significantly higher than that of severer side(6.7%),P<0.05.Conclusion

关 键 词：股骨头缺血坏死 坐骨股骨间隙 股方肌间隙 坐骨股骨撞击综合征 磁共振成像 

分 类 号：R681.8[医药卫生—骨科学] R445.2[医药卫生—外科学]