磁共振对坐骨-股骨撞击综合征的诊断价值

The Diagnostic Value of Magnetic Resonance Imaging in Ischiofemoral Impingement Syndrome

目的探讨坐骨-股骨撞击综合征（IFI）的MRI表现,提高对该病的早期诊断及治疗水平。方法回顾性分析86例经临床诊断为IFI及90名正常对照组髋关节MRI资料,由两位放射科医师分别测量股方肌间隙（QFS）、坐骨股骨间隙（IFS）及颈干角（IA）、腘绳肌肌腱区域（HTA）大小,评估股方肌（QFM）水肿及脂肪浸润程度。应用两独立样本t检验比较IFI患者组与正常对照组之间测量结果的差异,采用Fisher精确概率法比较两组间QFS的水肿程度及脂肪浸润程度差异,采用受试者工作特征（ROC）曲线得出QFS及IFS对IFI进行诊断的最佳阈值及敏感性和特异性,应用Pearson相关分析患者QFS、IFS、HTA、IA与年龄之间的相关性。结果 IFI患者IFS及QFS明显低于对照组,IA及HTA明显高于对照组,差异有统计学意义（P〈0.05）。QFS及IFS鉴别IFI患者及正常对照组的ROC曲线下面积（AUC）分别为0.936及0.976,QFS的敏感度及特异度分别为84.9%和95.6%,IFS的敏感度及特异度分别为94.2%和93.3%。IFS、QFS与年龄呈明显负相关性（r=-0.256,P〈0.05,r=-0.243,P〈0.05）。结论 MRI可为诊断IFI提供解剖及病理学依据,IFS及QFS狭窄、HTA及IA增加对早期诊断及治疗IFI具有重要临床价值。

Objective To investigate the MRI characteristics of the ischiofemoral syndrome and improve the early diagnosis and treatment of the disease. Methods The MRI images of 86 patients with ischiofemoral impingement syndrome and 90 cases of health control groups were analyzed retrospectively. The ischiofemoral space,quadratus femoral space,inclination angle,hamstring tendon area and the degree of quadratus edema and fatty infiltration were measured and assessed by two musculoskeletal radiologists. The measurements were compared between the two groups by using independent-sample t test. Fish analysis was used to compare the degree of quadratus edema and fatty infiltration between the two groups. We used the ROC analysis method to get the best threshold value of QFS and IFS,we also evaluated the sensitivity and specificity for the diagnosis of IFI. Pearson correlation analysis was applied to analyze the relevance among QFS,IFS,TA,IA and age. Results The measurements of IFS and QFS were significantly lower than those of control groups（ P 〈 0. 05）,the IA and the HTA measurements of the patients were significantly higher than those of control groups（ P 〈 0. 05）,the area of QFS and IFS to distinguish IFI patients with health control groups under the ROC curve was 93. 6% and 97. 6%. The sensitivity and specificity of QFS were 84. 9% and 95. 6%,the sensitivity and specificity of IFS were 94. 2% and 93. 3%. The IFS,QFS were significantly correlated with age（ r =-0. 256,P 〈 0. 05,r =-0. 243,P 〈 0. 05）. Conclusion MRI can provide the necessary anatomy and pathology evidence of IFI. The decrease of measurements in QFS and IFS and the increase of those in HTA and IA will have great value in the early diagnosis and treatment of IFI.