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Abstract：
OBJECTIVE: To compare the prevalence of femoral head decentration (FHD) on different MR imaging planes in patients undergoing direct/indirect hip MR arthrography (MRA) with asymptomatic controls and to evaluate its association with osseous deformities.
METHODS: IRB-approved retrospective single-center study of symptomatic hips undergoing direct or indirect hip MRA at 3 T. Asymptomatic participants underwent non-contrast hip MRI at 3 T. FHD was defined as a continuous fluid layer between the acetabulum and femoral head and assessed on axial, sagittal and radial images. The association of intra-articular/intra-venous contrast agents and the prevalence of FHD was evaluated. The association of FHD with osseous deformities and joint damage was assessed using multiple logistic regression analysis.
RESULTS: Three-hundred ninety-four patients (447 hips, mean age 31 ± 9 years, 247 females) were included and compared to 43 asymptomatic controls (43 hips, mean age 31 ± 6 years, 26 females). FHD was most prevalent on radial images and more frequent in symptomatic hips (30% versus 2%, p < 0.001). FHD prevalence was not associated with the presence/absence of intra-articular contrast agents (30% versus 22%, OR = 1.5 (95% CI 0.9-2.5), p = 0.125). FHD was associated with hip dysplasia (OR = 6.1 (3.3-11.1), p < 0.001), excessive femoral torsion (OR = 3.0 (1.3-6.8), p = 0.010), and severe cartilage damage (OR = 3.6 (2.0-6.7), p < 0.001).
CONCLUSIONS: While rare in asymptomatic patients, femoral head decentration in symptomatic patients is associated with osseous deformities predisposing to hip instability, as well as with extensive cartilage damage.
UNASSIGNED: Decentration of the femoral head on radial MRA may be interpreted as a sign of hip instability in symptomatic hips without extensive cartilage defects. Its presence could unmask hip instability and yield promise in surgical decision-making.
CONCLUSIONS: The best method of identifying femoral head decentration is radial MRI. The presence/absence of intra-articular contrast is not associated with femoral head decentration. Femoral head decentration is associated with hip deformities predisposing to hip instability.
METHODS: IRB-approved retrospective single-center study of symptomatic hips undergoing direct or indirect hip MRA at 3 T. Asymptomatic participants underwent non-contrast hip MRI at 3 T. FHD was defined as a continuous fluid layer between the acetabulum and femoral head and assessed on axial, sagittal and radial images. The association of intra-articular/intra-venous contrast agents and the prevalence of FHD was evaluated. The association of FHD with osseous deformities and joint damage was assessed using multiple logistic regression analysis.
RESULTS: Three-hundred ninety-four patients (447 hips, mean age 31 ± 9 years, 247 females) were included and compared to 43 asymptomatic controls (43 hips, mean age 31 ± 6 years, 26 females). FHD was most prevalent on radial images and more frequent in symptomatic hips (30% versus 2%, p < 0.001). FHD prevalence was not associated with the presence/absence of intra-articular contrast agents (30% versus 22%, OR = 1.5 (95% CI 0.9-2.5), p = 0.125). FHD was associated with hip dysplasia (OR = 6.1 (3.3-11.1), p < 0.001), excessive femoral torsion (OR = 3.0 (1.3-6.8), p = 0.010), and severe cartilage damage (OR = 3.6 (2.0-6.7), p < 0.001).
CONCLUSIONS: While rare in asymptomatic patients, femoral head decentration in symptomatic patients is associated with osseous deformities predisposing to hip instability, as well as with extensive cartilage damage.
UNASSIGNED: Decentration of the femoral head on radial MRA may be interpreted as a sign of hip instability in symptomatic hips without extensive cartilage defects. Its presence could unmask hip instability and yield promise in surgical decision-making.
CONCLUSIONS: The best method of identifying femoral head decentration is radial MRI. The presence/absence of intra-articular contrast is not associated with femoral head decentration. Femoral head decentration is associated with hip deformities predisposing to hip instability.
摘要：
目的：比较接受直接/间接髋关节磁共振成像（MRA）的患者在不同MR成像平面上股骨头偏心（FHD）的患病率，并评估其与骨畸形的相关性。
方法：IRB批准的回顾性单中心研究，有症状的髋关节在3T时接受直接或间接髋关节MRA。矢状和放射状图像。评估了关节内/静脉内造影剂与FHD患病率的关联。使用多元logistic回归分析评估FHD与骨畸形和关节损伤的关系。
结果：三百九十四个患者（447髋，平均年龄31±9岁，包括247名女性），并与43名无症状对照（43髋，平均年龄31±6岁，26名女性）。FHD在放射状图像上最普遍，在有症状的臀部中更常见（30％对2％，p<0.001)。FHD患病率与关节内造影剂的存在/不存在无关（30％对22％，OR=1.5（95%CI0.9-2.5），p=0.125）。FHD与髋关节发育不良相关（OR=6.1（3.3-11.1），p<0.001)，股扭转过度（OR=3.0（1.3-6.8），p=0.010),和严重的软骨损伤（OR=3.6（2.0-6.7），p<0.001)。
结论：虽然在无症状患者中很少见，有症状患者的股骨头偏心与骨畸形相关，易导致髋关节不稳定，以及广泛的软骨损伤。
■在没有广泛软骨缺损的有症状的髋关节上，股骨头的重心下降可能被解释为髋关节不稳定的迹象。它的存在可以掩盖髋关节不稳定，并在手术决策中产生希望。
结论：识别股骨头偏心的最佳方法是放射状MRI。关节内造影的存在/不存在与股骨头偏心无关。股骨头偏心与髋关节畸形有关，易导致髋关节不稳定。
方法：IRB批准的回顾性单中心研究，有症状的髋关节在3T时接受直接或间接髋关节MRA。矢状和放射状图像。评估了关节内/静脉内造影剂与FHD患病率的关联。使用多元logistic回归分析评估FHD与骨畸形和关节损伤的关系。
结果：三百九十四个患者（447髋，平均年龄31±9岁，包括247名女性），并与43名无症状对照（43髋，平均年龄31±6岁，26名女性）。FHD在放射状图像上最普遍，在有症状的臀部中更常见（30％对2％，p<0.001)。FHD患病率与关节内造影剂的存在/不存在无关（30％对22％，OR=1.5（95%CI0.9-2.5），p=0.125）。FHD与髋关节发育不良相关（OR=6.1（3.3-11.1），p<0.001)，股扭转过度（OR=3.0（1.3-6.8），p=0.010),和严重的软骨损伤（OR=3.6（2.0-6.7），p<0.001)。
结论：虽然在无症状患者中很少见，有症状患者的股骨头偏心与骨畸形相关，易导致髋关节不稳定，以及广泛的软骨损伤。
■在没有广泛软骨缺损的有症状的髋关节上，股骨头的重心下降可能被解释为髋关节不稳定的迹象。它的存在可以掩盖髋关节不稳定，并在手术决策中产生希望。
结论：识别股骨头偏心的最佳方法是放射状MRI。关节内造影的存在/不存在与股骨头偏心无关。股骨头偏心与髋关节畸形有关，易导致髋关节不稳定。
