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目的观察坐骨股骨撞击综合征(IFI)患者MRI影像学征象,探讨磁共振横断面不同测量指标对IFI的诊断价值。方法回顾性分析行髋关节MRI检查,确诊为IFI的32例患者(共62个髋关节)资料,作为病例组;另搜集29例排除IFI的患者共58个髋关节资料,作为对照组;在横断面T_1WI TSE序列像上测量坐骨股骨间隙(IFS)、股方肌间隙(QFS)、股方肌总体积(TQFMV)及腘绳肌腱面积(HTA)。结果病例组患者的IFS、QFS、TQFMV分别为(11.5±3.3)mm、(6.6±2.2)mm、(17.2±6.3)cm~3;对照组上述指标分别为(22.5±3.8)mm、(14.6±3.3)mm、(25.1±5.6)cm~3。上述各组数据病例组均小于对照组,差异有统计学意义(t值分别为-17.0,-16.53,-6.9;P值均<0.05)。病例组HTA值为(2.9±0.5)cm~2,对照组HTA值为(2.0±0.4)cm~2,病例组HTA大于对照组,差异有统计学意义(t值为9.8,P<0.05);病例组IFS与QFS、TQFMV间存在正相关关系(r值分别为0.833、0.687;P值均<0.05);HTA与QFS、TQFMV之间存在负相关关系(r值分别为-0.634、-0.815;P值均<0.05);IFS、QFS、TQFMV及HTA诊断界值分别为≤15.4、≤7.1、≤17.86、≥2.56;病例组患者水肿及脂肪浸润不同等级相应IFS之间差异不具有统计学意义(P>0.05)。结论 MRI检查发现IFS、QFS狭窄及股方肌水肿或脂肪浸润对诊断IFI有极其重要的诊断价值,可为临床诊断IFI、制定治疗方案及选择手术方式提供有力凭证。
Objective To observe the MRI features of the sciatic femur impingement syndrome (IFI) and to explore the diagnostic value of different measurements of magnetic resonance (MR) in the diagnosis of IFI. Methods Retrospective analysis of data of 32 patients with hip fracture (IFI) diagnosed as 32 cases (total 62 hips) were retrospectively analyzed. A total of 58 hip specimens from 29 patients with IFI were collected as control group. Cross sections of the T_1WI TSE sequence were measured on the ischial femur interspace (IFS), femoral interphalangeal space (QFS), total femoral muscle volume (TQFMV) and hamstring tendon area (HTA). Results The IFS, QFS and TQFMV were (11.5 ± 3.3) mm, (6.6 ± 2.2) mm and (17.2 ± 6.3) cm ~ 3 respectively in the case group and those in the control group were (22.5 ± 3.8) mm and ± 3.3) mm, (25.1 ± 5.6) cm ~ 3. The data of each group were less than the control group, the difference was statistically significant (t values were -17.0, -16.53, -6.9; P values were <0.05). HTA was (2.9 ± 0.5) cm ~ 2 in the case group and (2.0 ± 0.4) cm ~ 2 in the control group. The HTA in the case group was significantly higher than that in the control group (t = 9.8, P <0.05) ; There was a positive correlation between IFS and QFS and TQFMV in case group (r = 0.833,0.687, P <0.05). There was a negative correlation between HTS and QFS and TQFMV (r = -0.634, -0.815 ; P values were <0.05). The cutoffs of IFS, QFS, TQFMV and HTA were ≤15.4, ≤7.1, ≤17.86, ≥2.56 respectively. There was no statistical difference between the corresponding IFS of different grades of edema and fat infiltration in case group Significance (P> 0.05). Conclusion MRI examination shows that IFS, QFS stenosis and femoral muscle edema or fat infiltration are extremely important diagnostic value for the diagnosis of IFI. It can provide a powerful evidence for the clinical diagnosis of IFI, the development of treatment options and the selection of surgical methods.