标题：髋关节撞击综合征的MSCT影像学研究

      作者：张国权，李景    (洪泽区人民医院影像科，江苏 淮安 223100)

      卷次： 2018年29卷13期

      【摘要】 目的 探讨多层螺旋CT (MSCT)平扫、图像后处理重建技术和测量α角诊断髋关节撞击综合征(FAI)的价值。方法 选取2013年3月至2017年5月洪泽区人民医院行MSCT扫描，临床诊断为FAI的32例患者的影像和临床资料，回顾性分析髋关节解剖学、骨质异常情况和α角测量的意义。结果 所有患者中凸轮型8例、钳夹型9例、混合型15例；MSCT在显示FAI骨质细节中具有独特优势，特别是利用多平面重建(MPR)技术进行冠状面、矢状面、任意层面斜矢状位图像能够清晰显示FAI解剖学、细微骨质异常，其中呈典型“手抢柄”征5例，股骨颈疝窝7例，钳型9例，主要以髋臼异常表现为主，其中深髋臼2例，髋臼后倾3例，髋臼前方或后方过度覆盖4例；15例混合型FAI影像表现兼有凸轮型、钳型两者表现；本组所有FAI患者中，α角普遍增大，以凸轮型最大，范围55°~76°。结论 多排螺旋CT平扫和图像后处理技术清晰显示股骨头及髋臼解剖及骨质异常，结合α角等参数测量分析，能够准确诊断FAI，对临床治疗方案的选择具有重要价值。
      【关键词】 多排螺旋CT；髋关节撞击综合征；α角
      【中图分类号】 R684 【文献标识码】 A 【文章编号】 1003—6350（2018）13—1846—03

Multi-slice CT in the femoroacetabulur impingement syndrome.
ZHANG Guo-quan, LI Jing. Department ofRadiology, Hongze People's Hospital, Huaian 223100, Jiangsu, CHINA
【Abstract】 Objective To explore the value of multi-slice CT (MSCT), imaging reconstruction and measure-ment of α angle in diagnosing femoroacetabulur impingement syndrome (FAI). Methods The imaging and clinical da-ta of 32 patients diagnosed as FAI who underwent MSCT from March 2013 to May 2017 in Hongze People's Hospitalwere collected. The anatomy of hip, abnormal bone structure, and measurement of α angle were analyzed respectively.Results Among the 32 patients, there were 8 cases of Cam type, 9 cases of Pincer type, and 15 of mixed type. MSCT isadvantageous in displaying bone structure of FAI, especially with using multi-planner reformation (MPR) for anatomicalstructure of FAI and subtle bone abnormality (on coronal plane, sagittal plane oblique sagittal plane). There were 5 casesof typical pistol-grip signs, 7 cases of herniation pits, and 9 cases of Pincer type. The main manifestation is acetabular ab-normality, including 2 cases of deep acetabulum, 3 cases of acetabular retroversion, and 4 cases of anterior or posteriorovercoverage of acetabulum. The 15 cases of mixed type FAI had manifestations of both Cam type and Pincer type. In-crease of α angle was found in all the FAI patients, especially in Cam type, ranged from 55° to 76°. Conclusion MSCTand imaging reconstruction can well display the anatomy of femoral head and acetabulum, as well as bone abnormality,which, combined with measurement of α angle, can diagnose FAI accurately and has important value for selection oftherapeutic regimen.
      【Key words】 Multi-slice CT; Femoroacetabulur impingement syndrome; α angle·论 著·doi:10.3969/j.issn.1003-6350.2018.13.022