MRI测量对坐骨股骨撞击综合征的诊断价值

Diagnostic value of MRI measurement in ischiofemoral impingement syndrome

目的探讨MRI对坐骨股骨撞击综合征(IFIS)患者的诊断价值。方法回顾性分析70例IFIS患者(IFIS组)和40名健康志愿者(对照组)的MRI资料。于轴位脂肪抑制T2WI测量坐骨股骨间隙(IFS)宽度、股方肌间隙(QFS)宽度,于轴位T1WI测量坐骨角,于冠状位T2WI测量股骨颈干角,比较2组间的差异,分析IFS宽度与其他3个指标的相关性,绘制ROC曲线,评价其对IFIS的诊断效能。对IFIS组患者股方肌水肿和脂肪浸润程度进行分级,比较不同级别间IFS宽度的差异。结果 IFIS组患者IFS宽度、QFS宽度、坐骨角及股骨颈干角分别为(11.76±2.22)mm、(8.33±2.20)mm、(132.59±1.39)°和132.70(131.18,134.13)°,与对照组比较差异均有统计学意义(P均<0.001)。IFS宽度、QFS宽度、坐骨角度及股骨颈干角诊断IFIS的ROC曲线下面积分别为1.000、0.999、0.996和0.975(P均<0.001)。IFS宽度与QFS宽度呈正相关(r=0.743,P<0.001),与坐骨角度及股骨颈干角呈负相关(r=-0.273,P=0.022;r=-0.332,P=0.005)。IFIS组患者不同股方肌水肿、脂肪浸润分级间IFS宽度总体差异均有统计学意义(P均<0.05)。结论 IFIS患者IFS、QFS均明显狭窄;股方肌水肿及脂肪浸润是IFIS常见MRI表现。

Objective To investigate the diagnostic value of MRI in patients with ischiofemoral impingement syndrome(IFIS).Methods MRI data of 70 patients with IFIS(IFIS group)and 40 normal volunteers(control group)were analyzed retrospectively.The width of ischial femoral space(IFS)and quadratus femoris space(QFS)were measured on axial fat suppression T2 WI,while the angle of sciatic bone was measured on axial T1 WI,and the femoral neck shaft angle was measured on coronal T2 WI,and then were compared between the two groups.The correlation between the width of IFS and the other three parameters was analyzed,and ROC curve was drawn to evaluate the diagnostic efficacy for IFIS.The degree of edema and fat infiltration of the quadratus femoris in IFIS group were evaluated,and the differences of IFS width among different grades were compared.Results In IFIS group,the IFS width,QFS width,ischium angle and femoral neck shaft angle was(11.76±2.22)mm,(8.33±2.20)mm,(132.59±1.39)°and 132.70(131.18,134.13)°,respectively,and the differences between the two groups were statistically significant(all P<0.001).The area under ROC curve in diagnosis of IFIS with IFS width,QFS width,ischium angle and femoral neck shaft angle was 1.000,0.999,0.996 and 0.975,respectively(all P<0.001).There was positive correlation between IFS width and QFS(r=0.743,P<0.001),negative correlation between IFS width and ischium angle and femoral neck shaft angle(r=-0.273,P=0.022;r=-0.332,P=0.005).The overall differences in IFS width among different grades of femoral quadratus edema and fat infiltration in IFIS patients were statistically significant(both P<0.05).Conclusion IFS and QFS of IFIS patients are obviously narrow.Edema and fat infiltration of quadratus femoris are common MRI findings in IFIS patients.