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Abstract：
OBJECTIVE: To assess the feasibility of flexion-abduction-external rotation (FABER) magnetic resonance imaging (MRI) of the hip to visualize changes in the ischiofemoral interval and ability to provoke foveal excursion over the acetabular rim.
METHODS: IRB-approved retrospective single-center study. Patients underwent non-contrast 1.5-T hip MRI in the neutral and FABER position. Two readers measured the ischiofemoral interval at three levels: proximal/distal intertrochanteric distance and ischiofemoral space. Subgroup analysis was performed for hips with/without high femoral torsion, or quadratus femoris muscle edema (QFME), respectively. A receiver operating curve with calculation of the area under the curve (AUC) for the prediction of QFME was calculated. The presence of foveal excursion in both positions was assessed.
RESULTS: One hundred ten patients (121 hips, mean age 34 ± 11 years, 67 females) were evaluated. FABER-MRI led to narrowing (both p < .001) of the ischiofemoral interval which decreased more at the proximal (mean decrease by 26 ± 7 mm) than at the distal (6 ± 7 mm) intertrochanteric ridge. With high femoral torsion/ QFME, the ischiofemoral interval was significantly narrower at all three measurement locations compared to normal torsion/no QFME (p < .05). Accuracy for predicting QFME was high with an AUC of .89 (95% CI .82-.94) using a threshold of ≤ 7 mm for the proximal intertrochanteric distance. With FABER-MRI foveal excursion was more frequent in hips with QFME (63% vs 25%; p = .021).
CONCLUSIONS: Hip MRI in the FABER position is feasible, visualizes narrowing of the ischiofemoral interval, and can provoke foveal excursion.
UNASSIGNED: FABER MRI may be helpful in diagnosing ischiofemoral impingement and detecting concomitant hip instability by overcoming shortcomings of static MR protocols that do not allow visualization of dynamic changes in the ischiofemoral interval and thus may improve surgical decision making.
CONCLUSIONS: • FABER MRI enables visualization of narrowing of the ischiofemoral interval proximal to the lesser trochanter. • Proximal intertrochanteric distance of ≤ 7 mm accurately predicts quadratus femoris muscle edema. • Foveal excursion was more frequent in hips with quadratus femoris muscle edema.
METHODS: IRB-approved retrospective single-center study. Patients underwent non-contrast 1.5-T hip MRI in the neutral and FABER position. Two readers measured the ischiofemoral interval at three levels: proximal/distal intertrochanteric distance and ischiofemoral space. Subgroup analysis was performed for hips with/without high femoral torsion, or quadratus femoris muscle edema (QFME), respectively. A receiver operating curve with calculation of the area under the curve (AUC) for the prediction of QFME was calculated. The presence of foveal excursion in both positions was assessed.
RESULTS: One hundred ten patients (121 hips, mean age 34 ± 11 years, 67 females) were evaluated. FABER-MRI led to narrowing (both p < .001) of the ischiofemoral interval which decreased more at the proximal (mean decrease by 26 ± 7 mm) than at the distal (6 ± 7 mm) intertrochanteric ridge. With high femoral torsion/ QFME, the ischiofemoral interval was significantly narrower at all three measurement locations compared to normal torsion/no QFME (p < .05). Accuracy for predicting QFME was high with an AUC of .89 (95% CI .82-.94) using a threshold of ≤ 7 mm for the proximal intertrochanteric distance. With FABER-MRI foveal excursion was more frequent in hips with QFME (63% vs 25%; p = .021).
CONCLUSIONS: Hip MRI in the FABER position is feasible, visualizes narrowing of the ischiofemoral interval, and can provoke foveal excursion.
UNASSIGNED: FABER MRI may be helpful in diagnosing ischiofemoral impingement and detecting concomitant hip instability by overcoming shortcomings of static MR protocols that do not allow visualization of dynamic changes in the ischiofemoral interval and thus may improve surgical decision making.
CONCLUSIONS: • FABER MRI enables visualization of narrowing of the ischiofemoral interval proximal to the lesser trochanter. • Proximal intertrochanteric distance of ≤ 7 mm accurately predicts quadratus femoris muscle edema. • Foveal excursion was more frequent in hips with quadratus femoris muscle edema.
摘要：
目的：评估髋关节屈曲-外展-外旋（FABER）磁共振成像（MRI）的可行性，以可视化坐骨股间期的变化以及引起髋臼边缘中央凹偏移的能力。
方法：IRB批准的回顾性单中心研究。患者在中立和FABER位置进行了非对比1.5-T髋关节MRI检查。两名读者在三个水平上测量了坐骨股间隔：近端/远端转子间距离和坐骨股间隙。对有/没有股骨高扭转的髋关节进行亚组分析，或股方肌水肿（QFME），分别。计算用于预测QFME的具有曲线下面积(AUC)计算的接受者工作曲线。评估了两个位置中中央凹偏移的存在。
结果：一百一十名患者（121髋，平均年龄34±11岁，67名女性）进行了评估。FABER-MRI导致坐骨股间期变窄（均p<.001），近端（平均减少26±7mm）比远端（6±7mm）股骨粗隆间脊减少更多。股骨高扭转/QFME,与正常扭转/无QFME相比,所有三个测量位置的坐骨股间期均显著变窄(p<.05).预测QFME的准确性很高，AUC为.89（95％CI.82-.94），使用近端股骨转子间距离≤7mm的阈值。对于FABER-MRI，QFME患者髋部中央凹偏移更频繁(63%vs25%；p=.021)。
结论：FABER位置的髋关节MRI是可行的，可视化坐骨下颌间隔的缩小，可以引起中央凹游览。
■FABERMRI可能通过克服静态MR方案的缺点而有助于诊断坐肌撞击并检测伴随的髋关节不稳定，因为静态MR方案不能使坐肌间期的动态变化可视化，因此可以改善手术决策。
结论：•FABERMRI可显示小转子近端坐骨股间期狭窄。•股骨转子间近端距离≤7mm可准确预测股方肌水肿。•在伴有股方肌水肿的髋部中，中心凹偏移更为频繁。
方法：IRB批准的回顾性单中心研究。患者在中立和FABER位置进行了非对比1.5-T髋关节MRI检查。两名读者在三个水平上测量了坐骨股间隔：近端/远端转子间距离和坐骨股间隙。对有/没有股骨高扭转的髋关节进行亚组分析，或股方肌水肿（QFME），分别。计算用于预测QFME的具有曲线下面积(AUC)计算的接受者工作曲线。评估了两个位置中中央凹偏移的存在。
结果：一百一十名患者（121髋，平均年龄34±11岁，67名女性）进行了评估。FABER-MRI导致坐骨股间期变窄（均p<.001），近端（平均减少26±7mm）比远端（6±7mm）股骨粗隆间脊减少更多。股骨高扭转/QFME,与正常扭转/无QFME相比,所有三个测量位置的坐骨股间期均显著变窄(p<.05).预测QFME的准确性很高，AUC为.89（95％CI.82-.94），使用近端股骨转子间距离≤7mm的阈值。对于FABER-MRI，QFME患者髋部中央凹偏移更频繁(63%vs25%；p=.021)。
结论：FABER位置的髋关节MRI是可行的，可视化坐骨下颌间隔的缩小，可以引起中央凹游览。
■FABERMRI可能通过克服静态MR方案的缺点而有助于诊断坐肌撞击并检测伴随的髋关节不稳定，因为静态MR方案不能使坐肌间期的动态变化可视化，因此可以改善手术决策。
结论：•FABERMRI可显示小转子近端坐骨股间期狭窄。•股骨转子间近端距离≤7mm可准确预测股方肌水肿。•在伴有股方肌水肿的髋部中，中心凹偏移更为频繁。
