观察者间及观察者自身对股髋撞击综合征诊断的一致性研究
发布时间：2018-11-02 14:56
【摘要】：目的：验证两个独立阅片者对股骨髋臼撞击综合征（FAI）的诊断有无显著性差异；.对比同一阅片者前后两次诊断有无显著性差异。 材料和方法：本研究为一项临床回顾性研究，通过制度审查委员会批准，收集自2010年3月至2011年3月因髋部疼痛而在同一医院就诊的233位患者（年龄15-85岁，平均年龄42.7岁），总共466侧髋关节，患者均有过一项或多项影像学检查，，如X线、CT、磁共振。无其他临床病史，经如下影像学标准诊断为股骨髋臼撞击综合征：X线：骨性突起，手枪柄样畸形，头颈偏距＜9mm，“8”字征，后壁投影交叉征伴中心侧边缘角（LCE）＞40°，股骨头突出指数（FEI）＜25伴LEC＞40°；CT：由原始轴位CT图像重建冠状面和斜矢状面图像，显示有骨性突起，手枪柄样畸形，头颈偏距＜9mm，FEI＜25伴LEC＞40°，髋臼深度＞5mm；MRI：骨性突起，手枪柄样畸形，头颈偏距＜9mm，FEI＜25伴LEC＞40°，髋臼深度＞5mm。阅片由两名阅片人A和B独立完成，且阅片人A在一个月后再进行二次阅片。应用SPSS统计软件进行数据分析，采用科恩（Cohen）Kappa检验，评价两阅片人对FAI不同征象诊断的一致性。 结果：观察者间及观察者自身对骨性突起、手枪柄样畸形、股骨头颈偏距、后壁投影交叉征、股骨头突出指数及中心侧边缘角这些征象都显示了高度的一致性；对“8”字征显示有很好一致性；而对髋臼深度显示的一致性差。 结论：骨性突起、手枪柄样畸形、股骨头颈偏距、后壁投影交叉征结合中心侧边缘角和股骨头突出指数结合中心侧边缘角都是诊断FAI的可靠征象；“8”字征和髋臼深度不能作为诊断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 掳. Femoral head protrusion index (FEI) < 25) with LEC > 40 掳; 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 掳, acetabular depth > 5 mm. MRI: bony protuberance, pistol handle deformity, head and neck deviation < 9 mm FEI < 25 with LEC > 40 掳, 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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R684;R445
[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 掳. Femoral head protrusion index (FEI) < 25) with LEC > 40 掳; 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 掳, acetabular depth > 5 mm. MRI: bony protuberance, pistol handle deformity, head and neck deviation < 9 mm FEI < 25 with LEC > 40 掳, 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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R684;R445
【共引文献】
相关期刊论文 前10条
1 肖树恺;向子云;蔡汉寿;武胜;朱宇辉;;髋关节撞击综合征的多排螺旋CT诊断[J];中国CT和MRI杂志;2011年02期
2 王学松;杨涛;柳玉林;;髋关节撞击综合征[J];放射学实践;2011年04期
3 张磊;曹云;;股骨髋臼撞击—年轻人髋痛诱因[J];中国骨与关节损伤杂志;2009年07期
4 殷吉e
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