在股骨髋臼撞击综合征患者中，三维 CT 重建可比射线照相更灵敏地检测出钳状病变

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-06-01 DOI:10.1016/j.asmr.2024.100918

Cory D. Smith M.D., Evan Simpson B.S., Bailey Johnson M.D., Edward Quilligan B.S., Robert Grumet M.D., Kevin C. Parvaresh M.D.

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引用次数: 0

摘要

目的在接受髋关节镜手术治疗股骨髋臼撞击综合征（FAIS）的患者中，评估X光片（XR）与三维（3D）计算机断层扫描相比检测钳状病变的诊断能力。方法我们对2020年9月1日至2022年10月2日期间接受髋关节镜手术治疗股骨髋臼撞击综合征的所有患者进行了回顾性审查。对术前影像学进行了回顾。钳状病变的定义是：外侧中心-边缘角度大于 40°；Tönnis 角度大于 0°；存在峡部棘征、交叉征或后壁征；存在大于 80% 的过度覆盖。在 "选择标准 "下，仅根据X光片和三维计算机断层扫描重建（CTR）的外侧中心边缘角或Tönnis角将患者归类为钳状病变，而 "所有标准 "则增加了交叉征和覆盖率的存在。结果共有 69 名患者符合纳入标准。其中男性患者 21 人（30.4%），女性患者 48 人（69.6%）。选择标准的χ2分析发现，三维 CTR 比 XR 更有可能检测到钳状病变。χ2 对所有标准进行分析后发现，三维 CTR 比 XR 更有可能检测到钳状病变。χ2 分析进一步表明，使用 XRs 时，在所有标准下检测到钳状病变的可能性比在选择标准下检测到钳状病变的可能性大。结论在这项研究中，我们发现 3D CTR 在接受髋关节镜检查以治疗 FAIS 的患者中检测到钳状病变的灵敏度明显高于单独使用 XR。

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Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome

Purpose

To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods

We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under “select criteria,” patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas “all criteria” added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs.

Results

A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ² Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria.

Conclusions

In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone.