【摘要】：目的：驗(yàn)證兩個(gè)獨(dú)立閱片者對(duì)股骨髖臼撞擊綜合征（FAI）的診斷有無(wú)顯著性差異；.對(duì)比同一閱片者前后兩次診斷有無(wú)顯著性差異。 材料和方法：本研究為一項(xiàng)臨床回顧性研究，通過(guò)制度審查委員會(huì)批準(zhǔn)，收集自2010年3月至2011年3月因髖部疼痛而在同一醫(yī)院就診的233位患者（年齡15-85歲，平均年齡42.7歲），總共466側(cè)髖關(guān)節(jié)，患者均有過(guò)一項(xiàng)或多項(xiàng)影像學(xué)檢查，，如X線、CT、磁共振。無(wú)其他臨床病史，經(jīng)如下影像學(xué)標(biāo)準(zhǔn)診斷為股骨髖臼撞擊綜合征：X線：骨性突起，手槍柄樣畸形，頭頸偏距＜9mm，“8”字征，后壁投影交叉征伴中心側(cè)邊緣角（LCE）＞40°，股骨頭突出指數(shù)（FEI）＜25伴L(zhǎng)EC＞40°；CT：由原始軸位CT圖像重建冠狀面和斜矢狀面圖像，顯示有骨性突起，手槍柄樣畸形，頭頸偏距＜9mm，F(xiàn)EI＜25伴L(zhǎng)EC＞40°，髖臼深度＞5mm；MRI：骨性突起，手槍柄樣畸形，頭頸偏距＜9mm，F(xiàn)EI＜25伴L(zhǎng)EC＞40°，髖臼深度＞5mm。閱片由兩名閱片人A和B獨(dú)立完成，且閱片人A在一個(gè)月后再進(jìn)行二次閱片。應(yīng)用SPSS統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析，采用科恩（Cohen）Kappa檢驗(yàn)，評(píng)價(jià)兩閱片人對(duì)FAI不同征象診斷的一致性。 結(jié)果：觀察者間及觀察者自身對(duì)骨性突起、手槍柄樣畸形、股骨頭頸偏距、后壁投影交叉征、股骨頭突出指數(shù)及中心側(cè)邊緣角這些征象都顯示了高度的一致性；對(duì)“8”字征顯示有很好一致性；而對(duì)髖臼深度顯示的一致性差。 結(jié)論：骨性突起、手槍柄樣畸形、股骨頭頸偏距、后壁投影交叉征結(jié)合中心側(cè)邊緣角和股骨頭突出指數(shù)結(jié)合中心側(cè)邊緣角都是診斷FAI的可靠征象；“8”字征和髖臼深度不能作為診斷FAI的可靠征象。
[Abstract]:Objective: to verify the difference between two independent readers in the diagnosis of femoral acetabular impingement syndrome (FAI). There was significant difference between the two diagnoses before and after the same film reading. Materials and methods: this study, a clinical retrospective study, was approved by the system Review Committee to collect 233 patients aged 15-85 who were admitted to the same hospital for hip pain from March 2010 to March 2011. An average age of 42.7 years), a total of 466 hip joints, all patients had one or more imaging examinations, such as X-ray, CT, MRI. There was no other clinical history. According to the following imaging criteria, the femoral acetabular impingement syndrome was diagnosed as follows: X ray: bone protuberance, pistol handle deformity, head and neck deviation < 9mm, "8" sign, posterior wall projection cross sign with (LCE) > 40 擄. Femoral head protrusion index (FEI) < 25) with LEC > 40 擄; CT: reconstructed coronal and oblique sagittal images from original axial CT images, showing bony protrusions, handgun shank deformities, head and neck deviation < 9 mm FEI < 25 with LEC > 40 擄, acetabular depth > 5 mm. MRI: bony protuberance, pistol handle deformity, head and neck deviation < 9 mm FEI < 25 with LEC > 40 擄, acetabular depth > 5 mm. The film was read by two film readers A and B, and a second time after one month. SPSS statistical software was used to analyze the data and Cohen (Cohen) Kappa test was used to evaluate the consistency of the two film readers in the diagnosis of different signs of FAI. Results: the interobserver and the observer showed a high degree of consistency on the bone protrusions, handgun shank deformities, neck deviation of the femoral head, projection cross-sign of the posterior wall, femoral head protrusion index and center-lateral margin angle. There was good consistency for the sign of "8", but poor consistency for the depth of acetabulum. Conclusion: bony protuberance, pistol handle deformity, neck deviation of femoral head, posterior wall projection cross sign combined with central margin angle and femoral head protrusion index combined with central edge angle are reliable signs for diagnosis of FAI. The "8" sign and acetabular depth are not reliable signs for the diagnosis of FAI.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R684;R445

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 肖樹愷;向子云;蔡漢壽;武勝;朱宇輝;;髖關(guān)節(jié)撞擊綜合征的多排螺旋CT診斷[J];中國(guó)CT和MRI雜志;2011年02期

2 王學(xué)松;楊濤;柳玉林;;髖關(guān)節(jié)撞擊綜合征[J];放射學(xué)實(shí)踐;2011年04期

3 張磊;曹云;;股骨髖臼撞擊—年輕人髖痛誘因[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2009年07期

4 殷吉e

本文編號(hào)：2306125