摘要
目的应用MSCT在无症状的成年人髋关节中测量FAI相关的形态学定量参数,确立这些参数的均值及参考区间,为进一步临床应用和研究提供参考。方法选取2017年1月至2017年12月符合纳入标准及排除标注的240例有腹部或泌尿生殖系统病变患者,且所有患者均为行CT检查的年轻成年人,计算凸轮型髋关节撞击综合征的a角及股骨头颈交界处偏心距;钳型髋关节撞击综合征的髋臼前倾角、中心边缘角、髋臼交叉征;对上述影像学形态参数进行统计学数据定量分析。结果凸轮型撞击相关形态学参数,α角为51°(SD 9)和股骨头颈交界处偏心距为9mm(SD 2),钳型撞击相关形态学参数,髋臼前倾角为19°(SD 6),中心外侧角为32°(SD 6);凸轮型相关形态学参数均值及95%参考区间远远超出目前文献中界定异常阈值,而在钳型中超出程度略小。不同性别间参数在凸轮型中相近,而钳型中略有差异。结论无髋关节症状的髋关节撞击综合征(FAI)年轻成年人形态学测量值的95%参考区间超出异常范围阈值,形态学参数在成像时应该谨慎使用,特别是a角不是定义凸轮型FAI的合适参数,需要重新定义,这个参数似乎反映的是正常的解剖变异。FAI是一种临床诊断,无症状患者的预防性手术不应仅基于影像学征象。
Objective To use MSCT to measure FAI-related morphological quantitative parameters in asymptomatic adult hip joints and toestablish the mean value and reference interval of these parameters, so as to provide reference for further clinical application and research. Methods240 patients with abdominal or genitourinary diseases who met the inclusion criteria and excluded from labeling from January 2017 to December 2017.All patientswere young adults who underwent CT examination.In the patients withcam type hip impact syndrome, the angle A and the eccentricity atthe junction of femoral head and neck were calculated.In the patients withforceps type hip impact syndrome, the acetabular anteversion angleandcentral margin angle and acetabular cross sign werecalculated.All of themorphological parameters were quantitatively analyzed. Results In thecam type hip impact group, the A anglewas 51毅（SD 9） and eccentricity at the joint of femoral head and neck was 9mm （SD 2）. And in the forceps typehip impact group, the acetabular anteversion anglewas19毅（SD 6） and central lateral angle was 32毅（SD 6）. The mean value and 95 % reference intervalof the relevant morphological parameters of the cam type was far exceed the abnormal threshold defined in the current literature, while the exceedingdegree wasslightly smaller in the clamp type. The parameters between different genders weresimilar in cam type, but slightly different in clamp type.Conclusion The 95% reference interval of the morphological measurements of young adults with hip impact syndrome without hip joint symptomsexceeds the threshold of abnormal range. Morphological parameters should be carefully used in imaging, especially angle A is not an appropriateparameter to define convex wheel FAI and needs to be redefined. This parameter seems to reflect normal anatomical variation. FAI is a clinicaldiagnosis. Preventive surgery for asymptomatic patients should not be based solely on imaging findings.
作者
钱建敏
戴文字
金丽君
程建敏
QIAN Jianmin;DAI Wenzi;JIN Lijun(Tangxia People＇s Hospital of Ruian City,Zhejiang 325200,China)
出处
《浙江创伤外科》
2018年第5期860-863,共4页
Zhejiang Journal of Traumatic Surgery
基金
浙江省2017温州市科技项目编号:2017B19
