MRI及多层螺旋CT在测量股骨扭转角中的应用价值

Application value of MRI and multislice spiral CT in measuring femoral torsion angle

目的分析磁共振成像(magneticresonanceimaging,MRI)及多层螺旋计算机断层扫描(computedtomography,CT)在测量股骨扭转角中的应用价值。方法选取2019年1月至2022年6月于杭州市第九人民医院接受骨盆MRI及CT检查的髋关节疼痛患者51例(65髋)为研究对象。采用MRI与多层螺旋CT的4种常用测量方法评估股骨扭转角,分析其可重复性及一致性,并比较4种参考轴之间股骨扭转角的差异。结果MRI与多层螺旋CT用于评估股骨扭转角观察者间与观察者内的组内相关系数(intra-class correlation coefficient,ICC)均≥0.97。MRI与多层螺旋CT用于评估股骨扭转角的差值均数在0.23°~1.11°之间,MRI与多层螺旋CT不同水平股骨近端参考轴测量所得的股骨扭转角比较差异均无统计学意义(P>0.05)。大转子参考轴观察者间ICC差异在1个标准差内的占比为72.31%(47/65),股骨颈参考轴为87.69%(57/65),股骨颈基部参考轴为67.69%(44/65),小转子参考轴为78.46%(51/65)。结论MRI与多层螺旋CT不同水平股骨近端参考轴评估股骨扭转角的一致性和可重复性差别不大,但MRI无辐射,可减少患者有效辐射剂量。此外,不同水平近端参考轴可直接影响股骨扭转角的测量结果。

Objective To analyze the application value of magnetic resonance imaging(MRI)and multislice spiral computed tomography(CT)in measuring femoral torsion angle.Methods From January 2019 to June 2022,51 patients(65 hips)with hip joint pain who underwent pelvic MRI and CT examinations in Hangzhou Ninth People’s Hospital were selected as the study objects.Four commonly used measurement methods of MRI and multislice spiral CT were used to evaluate the femoral torsion angle,analyze its repeatability and consistency,and compare the difference of femoral torsion angle between four horizontal proximal femoral reference axes.Results The interobserver and intraobserver intra-class correlation coefficient(ICC)of MRI and multislice spiral CT for evaluating femoral torsion angle was≥0.97.The mean difference between MRI and multislice spiral CT for evaluating femoral torsion angle ranged from 0.23°to 1.11°.There was no significant difference between the femoral torsion angle measured by MRI and multislice spiral CT at different levels of proximal femoral reference axis(P>0.05).The ICC difference between observers of the greater trochanter reference axis accounted for 72.31%(47/65)within 1 standard deviation,the reference axis of the femoral neck was 87.69%(57/65),the reference axis of the femoral neck base was 67.69%(44/65),and the reference axis of the lesser trochanter was 78.46%(51/65).Conclusion The consistency and repeatability of the proximal femoral reference axis at different levels of MRI and multislice spiral CT used to evaluate the femoral torsion angle have little difference,but MRI has no radiation,which can reduce the effective radiation dose.In addition,different levels of proximal reference axis can directly affect the measurement results of femoral torsion angle.