| Objective:For two groups of normal hip joint and hip pain subjects, this study analyzed acetabular morphological changes of different gender and age by using MR imaging. The purpose is to assess the feasibility of MRI for diagnosing femoral acetabular impingement syndrome (femoroacetabular impingement, FAI) and probing the relationship between the acetabular development and hip pain, which aim at providing a reliable theoretical basis for the correct clinical diagnosis and early treatment.Materials and Methods:1.This study retrospectively analyzed290cases of double hip MRI scan data. The subjects were divided into the FAI and control groups. FAI group included170cases with the course of3months to30years(89women and81men;range21-83years; mean age51years). Control group included120cases(58women and62men; range,20～79years, mean age52years). FAI group inclusion criteria:①More than20years old with hip and/or groin area pain more than3months;②Hip impact test positive;③No congenital hip dysplasia (CE angle greater than20°) and other serious deformity;④No rheumatoid arthritis, ankylosing spondylitis and hip surgical history;⑤The scanning position standard and bilateral hip symmetry. In all subjects, there was no avascular necrosis, hip arthritis, cancer and trauma history. Severe degenerative joint disease was also excluded.2.Data were obtained on a1.5T unit (Symphony; Siemens, Erlangen,Germany) by using a surface receiver coil. Axial/coronal spin-echo T1-weighted sequence (SE-T1WI), turbo spin-echo T2-weighted sequence (TSE-T2WI) and coronal short time inversion recovery sequence (STIR) were used for scanning.3.Measurement methods:For the FAI group and control group, acetabulars were measured by using axial MR imaging. Acetabular anteversion, acetabular section angle and hip acetabular depth were measured in the center image of femoral head, respectively. Double-blind method was used to measure each group data twice with same measurement standards by two doctors. The average values of the four groups were obtained.4. After the overall analysis for the two groups of different age and gender, the mean values and standard deviation of the acetabular anteversion, the acetabular anterior section angular and the axial depth of the acetabulum were analyzed by using independent samples t test. All tests for statistical significance were performed for2-tailed hypotheses with P<0.05.Results:1.In this study, there was a total of366hips.FAI group:236hips(111male hips,125female hip).FAI of the left side was116, the right side was120. Control group:130hips(66male hips,64female hip), the left side was70, the right side was60.There was no statistical significance (P>0.05) between two groups of gender, age, left/right side.2.For the FAI group, the mean value of acetabular anteversion (12.58±3.33°) and acetabular section angle (45.15±3.35°) were less than the control group, while the axial hip acetabular depth (2.72±0.27cm) was more than the control group. There were statistically significances between two groups in acetabular anteversion, acetabular section angle and hip acetabular depth (P<0.05).3.The FAI and control group were divided into six subgroups by every10-year-old age. For FAI group, the acetabular anteversion and acetabular section angle of the each age group were obviously less than the control group. For the FAI group and control group in each age level, the difference of the acetabular anteversion and the acetabular section angle was statistically significant, respectively (P0.01). Two groups of acetabular depth(20～29,40～49,50～59,60～69years old level) difference was statistically significant(P<0.01);while the difference of30～39years old and more than70-year-old age was no statistical significance (P>0.05).4. For different gender, the difference within the two groups was statistically significant in the acetabular anteversion and acetabular depth(p<0.05); while acetabular section angle difference had no statistical significance (P>0.05).The male acetabular anteversion was smaller than female, and the male axial acetabular depth was also deepen than the female.5.For different gender, the difference between the two groups was statistically significant in the acetabular anteversion, the hip acetabular section angle and the acetabular depth(P<0.05).Both the male acetabular anteversion and the hip acetabular section angle were smaller than female, and the male axial acetabular depth was also deepen than the female.Conclusions:1. The acetabular anteversion and acetabular section angle of the FAI group are less than the normal control group, while the axial depth of the acetabular of the FAI group was deepen than the control group. It prompts that smaller the acetabular anteversion and acetabular section angle, and deepen acetabular depth increase the possibility prone to the FAI.2. The comparisons of acetabular anteversion,acetabular section angle and axial acetabular depth between the FAI and control groups for different age levels have shown such features as follows. For both groups, the smallest acetabular anteversion angle were observed in the age level above70years old, which suggests that the acetabular anteversion has physiological smaller trend in70-year-old age level.3. In FAI group, both the smallest acetabular section angle and the deepest hip acetabular depth were observed in the20～29years old age level, which prompts that the FAI is prone to attack in this age.4.Comparisons between and within the FAI group and the normal control group have shown that male acetabular anteversion, acetabular section angle were less than females, the male axial acetabular depth was deepen than females. Compared with women, whether men are prone to be attacked by FAI should be further researched and validated. |
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