无症状髋关节前上盂唇撕裂超声与磁共振检查的对比研究

doi:10.19723/j.issn.1671-167X.2023.04.016

摘要/Abstract

摘要：

目的: 探索超声对于无症状髋关节盂唇撕裂(acetabular labral tears，ALT)的诊断价值。方法: 2018年8月至2020年2月招募64例无髋关节症状志愿者(101髋)进行单髋3.0T磁共振及超声检查，其中男31例，女33例，中位年龄35(32，39)岁。以单髋磁共振诊断结果作为金标准，计算超声诊断ALT的敏感度、特异度、阳性预测值、阴性预测值和准确度。结果: 33例(51.56%)无症状志愿者存在单侧或双侧ALT，共47髋(46.53%)。行双侧髋关节磁共振检查的37例志愿者中14例存在双侧ALT，8例存在单侧ALT；行单侧髋关节磁共振检查的27例志愿者中，11例存在ALT。33例ALT患者中，男11例，女22例；右髋30例，左髋17例。ALT组中位年龄36(33，40)岁，无ALT组中位年龄34(32，38)岁，两组间差异无统计学意义(P>0.05)。盂唇异常的超声表现包括盂唇内裂隙26例、盂唇回声不均匀25例、盂唇旁囊肿2例、盂唇内局灶强回声12例。超声诊断无症状人群ALT敏感度、特异度、阳性预测值、阴性预测值和准确度分别为73.53%、67.16%、53.19%、83.33%和69.31%。本组髋关节前上盂唇中位横截面积为0.20(0.15，0.24) cm²，其中ALT组和无ALT组分别为0.22(0.17，0.28) cm²和0.17(0.14，0.21)cm²，两者差异有统计学意义(P < 0.001)。结论: ALT在无症状志愿者磁共振检查中常见，盂唇内裂隙、盂唇回声不均匀是其常见的超声征象；无症状志愿者中ALT组盂唇较无ALT组肿胀。

关键词: 髋关节盂唇撕裂, 无症状疾病, 患病率, 超声检查, 磁共振成像

Abstract:

Objective: To explore the diagnostic value of ultrasound for asymptomatic anterosuperior acetabular labral tears (ALT). Methods: From August 2018 to February 2020, a total of 64 asymptomatic volunteers (101 hips) were recruited to complete 3.0T magnetic resonance imaging (MRI) and ultrasound examination. Among these asymptomatic volunteers, 31 were male and 33 were female, with the median age 35 (32, 39) years. Using 3.0T MRI findings as golden standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound were calculated. Results: The results showed the presence of unilateral or bilateral ALT in 33 (51.56%) asymptomatic vo-lunteers with a total of 47 hips (46.53%). Of the 37 asymptomatic volunteers with bilateral hip MRI examination, 14 had bilateral ALT and 8 had unilateral ALT. Of the 27 asymptomatic volunteers who underwent unilateral hip MRI, 11 had ALT. Of the 33 asymptomatic volunteers with labral tears, 11 were male and 22 were female, with 30 right hips and 17 left hips. The median age was 36 (33, 40) years in the ALT group and 34 (32, 38) years in the non-ALT group. There was no significant difference in age between the two groups (P > 0.05). In the asymptomatic population, the abnormal anterosuperior acetabular labrum manifestations on ultrasound were intra-labrum cleft in 26 cases, labral heterogeneous echogenicity in 25 cases, paralabral cysts in 2 cases, and labral focal hyperechoic area in 12 cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for ALT diagnosed by ultrasound were 73.53%, 67.16%, 53.19%, 83.33% and 69.31%, respectively. The cross- sectional area (CSA) of the anterosuperior acetabular labrum was 0.20 (0.15, 0.24) cm² in this study. The labral median CSA of the ALT group and non-ALT group were 0.22 (0.17, 0.28) cm² and 0.17 (0.14, 0.21) cm², respectively, with a statistically significant difference (P < 0.001). Conclusion: The ALT are common findings in asymptomatic volunteers on MRI. Intra-labrum cleft and labral heterogeneous echogenicity are common ultrasonographic signs in asymptomatic volunteers with ALT. The labra were more swollen in the asymptomatic volunteers with ALT compared to those without ALT.

Key words: Acetabular labral tears, Asymptomatic diseases, Prevalence, Ultrasonography, Magnetic resonance imaging

中图分类号:

R684

傅强,高冠英,徐雁,林卓华,孙由静,崔立刚. 无症状髋关节前上盂唇撕裂超声与磁共振检查的对比研究[J]. 北京大学学报（医学版）, 2023, 55(4): 665-669.

Qiang FU,Guan-ying GAO,Yan XU,Zhuo-hua LIN,You-jing SUN,Li-gang CUI. Comparative study of ultrasound and magnetic resonance imaging in the diagnosis of asymptomatic anterosuperior acetabular labrum tears[J]. Journal of Peking University (Health Sciences), 2023, 55(4): 665-669.

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