Significant systematic bias of alpha angles measured on MRI compared to various radiographic views in patients with femoroacetabular impingement syndrome

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-11 DOI:10.1002/ksa.12446

Jairo Triana, Dhruv S. Shankar, Michael A. Moore, Berkcan Akpinar, Kinjal D. Vasavada, Christopher J. Burke, Mohammad M. Samim, Thomas Youm

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Abstract

Purpose

The aim of this study was to assess the inter-rater reproducibility and inter-method comparability of hip alpha angle measurements on magnetic resonance imaging (MRI)/magnetic resonance arthrography (MRA) and plain radiographs in patients with femoroacetabular impingement syndrome (FAIS).

Methods

A cross-sectional study of patients who were diagnosed with symptomatic FAIS underwent preoperative MRI/MRA with axial oblique and/or radial plane imaging and had preoperative radiographs with anterior-posterior (AP), 45° Dunn and 90° Dunn views. Alpha angle measurements were performed independently by two musculoskeletal radiologists. Inter-rater reproducibility and inter-method comparability between MRI/MRA images and radiographic views were assessed using the intraclass correlation coefficient (ICC) with 95% confidence interval (CI).

Results

Ninety-seven patients were included of whom 93 (95.8%) received axial oblique plane images and 54 (55.6%) had radial plane MRI/MRA images. Inter-rater reproducibility was excellent (ICC > 0.9) for all planes on MRI/MRA and radiographs. MRI/MRA axial oblique images had poor (ICC 0.39, 95% CI [0.09, 0.59]), moderate (ICC 0.57, 95% CI [0.18, 0.75]) and moderate (ICC 0.64, 95% CI [0.20, 0.81]) comparability with AP, 45° Dunn and 90° Dunn, respectively. MRI/MRA radial plane images had equivocal (0 included in all CIs) comparability with AP (ICC 0.66), 45° Dunn (ICC 0.35) and 90° Dunn (ICC 0.14) radiographs. On average, alpha angle measurements were significantly higher with radial images and lower with axial oblique images, when compared to all radiographic views (p < 0.05), except axial oblique versus 45° Dunn views, where angles measured on axial oblique were significantly larger.

Conclusion

Alpha angle measurements taken on axial oblique MRI/MRA images show moderate comparability to radiographic 45° Dunn and 90° Dunn views despite negative bias to measurements taken on radiographic AP and 45° Dunn view. Larger alpha angles were appreciated on MRI/MRA radial and axial oblique views compared to radiographic views supporting the inclusion of MRI/MRA alpha angle measurements to properly identify deformity.

Level of Evidence

Level II.

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在股骨髋臼撞击综合征患者中，磁共振成像测量的阿尔法角与各种放射学视图相比存在显著的系统性偏差。

目的本研究旨在评估股骨髋臼撞击综合征（FAIS）患者在磁共振成像（MRI）/磁共振关节造影（MRA）和普通X光片上髋关节α角测量的评分者间可重复性和方法间可比性。方法对确诊为无症状股骨髋臼撞击综合征（FAIS）的患者进行横断面研究，这些患者术前接受了轴向斜面和/或径向平面成像的 MRI/MRA，术前接受了前-后（AP）、45° Dunn 和 90° Dunn 切面的X光检查。α角测量由两名肌肉骨骼放射科医生独立完成。使用带 95% 置信区间 (CI) 的类内相关系数 (ICC) 评估 MRI/MRA 图像和放射学视图之间的评分者间可重复性和方法间可比性。结果共纳入 97 名患者，其中 93 人（95.8%）接受了轴向斜面图像，54 人（55.6%）接受了径向平面 MRI/MRA 图像。MRI/MRA 和射线照片上所有平面的评分者间再现性都非常好（ICC > 0.9）。MRI/MRA 轴向斜面图像与 AP、45° Dunn 和 90° Dunn 的可比性分别为差（ICC 0.39，95% CI [0.09，0.59]）、中（ICC 0.57，95% CI [0.18，0.75]）和中（ICC 0.64，95% CI [0.20，0.81]）。MRI/MRA 放射平面图像与 AP（ICC 0.66）、45° Dunn（ICC 0.35）和 90° Dunn（ICC 0.14）射线照片的可比性不明确（所有 CI 均为 0）。平均而言，与所有射线照相视图相比，径向图像的α角测量值明显更高，而轴向斜角图像的α角测量值更低（P < 0.05），但轴向斜角与 45° Dunn 视图相比除外，在轴向斜角上测量的角度明显更大。与放射学切面相比，MRI/MRA径向和轴向斜切面上的α角更大，这支持将MRI/MRAα角测量纳入正确识别畸形的方法中。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).