MRI联合MSCT检查对坐骨股骨撞击综合征的诊断价值及临床意义

Diagnostic value and clinical significance of MRI combined with MSCT in ischiofemroal impingement syndrome

目的探讨磁共振成像(MRI)测定股方肌总体积(TQFMV)、坐骨角、股骨颈前倾角(FNV)结合多层螺旋CT(MSCT)测定偏心距、小转子高径对坐骨股骨撞击综合征(IFI)的诊断价值及临床意义。方法前瞻性选取2017年10月至2020年7月北京怀柔医院收治的82例IFI患者作为观察组,另收集行MRI、MSCT检查的健康者82例作为对照组。比较2组一般资料、MRI、MSCT参数;logistic回归分析IFI的影响因素;分析MRI、MSCT参数与临床表现的关系及MRI参数与MSCT参数的相关性;采用受试者工作特征(ROC)曲线评价MRI、MSCT参数对IFI的诊断价值。结果两组性别、年龄、MRI参数(TQFMV、坐骨角、FNV)、MSCT参数(偏心距、小转子高径)比较,差异有统计学意义(均P<0.05);经logistic回归分析可知,性别、年龄、MRI参数(TQFMV、坐骨角、FNV)、MSCT参数(偏心距、小转子高径)均为IFI发病的影响因素(均P<0.05);MRI参数(TQFMV、坐骨角、FNV)、MSCT参数(偏心距、小转子高径)均与IFI患者股方肌(QFM)水肿、脂肪浸润及疼痛程度有关(均P<0.05);IFI患者TQFMV与MSCT参数偏心距、小转子高径呈正相关(均P<0.05),坐骨角、FNV与MSCT参数偏心距、小转子高径呈负相关(均P<0.05);绘制ROC曲线,MRI参数(TQFMV、坐骨角、FNV)、MSCT参数(偏心距、小转子高径)诊断IFI的AUC值均较高,尤以联合诊断最高,达0.859。结论MRI参数TQFMV、坐骨角、FNV和MSCT参数偏心距、小转子高径与IFI患者临床表现有关,联合检测可提高对IFI的诊断价值,避免漏诊误诊。

Objective To explore the diagnostic value and clinical significance of total volume of quadratus femoris muscle(TQFMV),ischial angle,femoral neck angle(FNV)measured by magnetic resonance imaging(MRI)combined with eccentric distance and lesser trochanter height measured by multi-slice spiral CT(MSCT)in the diagnosis of ischiofemoral impingement(IFI)syndrome.Methods A total of 82 patients with IFI in Beijing Huairou Hospital from October 2017 to July 2020 were selected as the observation group.In addition,82 healthy patients who underwent MRI and MSCT were collected as the control group.The general data,MRI and MSCT parameters of the two groups were compared,and IFI influencing factors were analyzed by logistic regression.The correlation between MRI and MSCT parameters and clinical manifestations and the correlation between MRI and MSCT parameters were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of MRI and MSCT parameters for IFI.Results There were statistically significant difference between the two groups of gender,age,MRI parameters(TQFMV,ischial angle,FNV),and MSCT parameters(eccentricity,lesser trochanter height)(all P<0.05).Logistic regression analysis showed that gender,age,MRI parameters(TQFMV,ischial angle,FNV),MSCT parameters(eccentricity,lesser trochanter height)were all influencing factors of IFI(all P<0.05).MRI parameters(TQFMV,ischial angle,FNV),MSCT parameters(eccentricity,lesser trochanter height)were all related to quadratus femoris muscle(QFM)edema,fat infiltration and pain degree in IFI patients(all P<0.05).The MRI parameter TQFMV of IFI patients was positively correlated with the MSCT parameter eccentricity and lesser trochanter height,while the ischial angle and FNV were negatively correlated with the MSCT parameter eccentricity and lesser trochanter height(all P<0.05).The AUC of MRI parameters(TQFMV,ischial angle,FNV)and MSCT parameters(eccentricity,lesser trochanter height)in the diagnosis of IFI were high,especially the highest in combined diagnosis,reaching 0.859.Conclusions MRI parameters TQFMV,ischial angle,FNV and MSCT parameters,eccentricity and lesser trochanter height are related to the clinical manifestations of IFI patients.Combined detection of them can improve the diagnostic value of IFI and avoid missed diagnosis and misdiagnosis.