Research Of Radiology And Application Value Of Quantitative Measurements For Ischiofemoral Impingement With MRI

Part 1 Research of Radiology for ischiofemoral impingement with MRIObjective:To describe the magnetic resonance imaging(MRI)findings in patients with ischiofemoral impingement(IFI)and to evaluate the reliability of these MRI findings.Methods:32 cases(62 hips)of patients with clinical diagnosis of ischiofemoral impingement were treated as patient group and the other 29 cases(58hips)who had been excluded of IFI by clinicians were treated as control group.Ischiofemoral space(IFS),quadratus femoris space(QFS),total QFM volume(TQFMV)and hamstring tendon area(HTA)were evaluated on T1 WI SE axial magnetic resonance imaging.Independent sample t test were used to compare the differences of these measurements.ROC was used to calculate the area under curve(AUC)and to define the diagnostic threshold value of each measurs.Pearson correlation was used to analyze the correlation of the measurements in each group.The edema of the femoral muscle was observed on the cross section of the PDWI FS sequence.The fatty replacement in the femoral muscle of the patient was observed on the transverse T1 WI SE sequence image.Statistical analysis was performed on IFS of different levels of muscle edema and fatty degeneration in the patient groupResults:IFS,QFS and TQFMV in patients were(11.5±3.3)mm,(6.6±2.2)mm,(17.2±6.3)cm3,while these measurements were(22.5±3.8)mm,(14.6±3.3)mm,(25.1±5.6)cm3 in control group,These measurements were significantly lower in patients than those in control group(t value were-17.0,-16.53,-6.9,P<0.05).HTA was significantly higher in patients than those incontrol group [(2.9±0.5)cm2 vs(2.0±0.4)cm2,t value was 9.8,P<0.05].There was a positive correlation between IFS and QFS,TQFMV in the patient group(r value were 0.833?0.687,P<0.05),TQFMV,QFS have significant negative correlation with HTA in patients(r value were-0.634?-0.815,P<0.05).Cut-off values of IFS,QFS,TQFMV and HTA were ?15.4,?7.1,?17.86 and ?2.56,IFS of the different level of edema and fatty replacement in patient group showed no statistically significant difference(P>0.05).Conclusions:MRI should be obtained for the presence of the QFM edema/fatty replacement,narrowing of the IFS-QFS,which may help in the clinical diagnosis of IFI for the proper diagnosis and treatment of the disease.Part 2 Application value of quantitative measurements Magnetic resonance images for ischiofemoral impingementPurpose:To explore the diagnostic value of quantitative measurements on MRI transverse section and coronary section in patients with ischiofemoral impingement,strengthen the cognition to the MRI performance of IFI,improve the ability of diagnosis and differential diagnosis of IFI.Methods:The data of 70 cases of patients(127hips)who were performed with Hip MRI examination in the Affiliated Hospital of Chengde Medical College from2013 June to 2016 April were retrospectively analyzed.39 cases(67 hips)of patients with clinical diagnosis of ischiofemoral impingement were treated as case group,while the other 31 cases(60 hips)of patients who had been excluded of IFI by clinicians were treated as control group.Ischial angel,femoral neck angel(FNA)and lesser trochanter angel(LTA)were measured on axial MR image with PDWI FS sequence,cervicodiaphyseal angle(CCD)were measured on coronary section MR image with T2 WI TIRM sequence.The measurements of the two groups were compared respectively.Results:LTA in patients of case group was 13.8°±0.7°,while this measurement was 19.9°±1.0° in patients of control group.This measurement was significantly lower in patients of case group than that in patients of control group(P<0.01).FNA,ischial angel were significantly higher in patients of case group than those in patients of control group(131.2°±0.4° vs 127.1°±0.6°,29.2°±11.3°vs 22.7°±9.3°,P<0.01).CCD showed no significant difference between the two groups(P>0.05).Cut-off values of QFS,FNA,Ischial angel and LTA were ?12.7mm,?21.75°,?131.65°,?9.3°.Conclusions:Ischial angel,FNA and LTA have important value for the diagnosis of IFI,furthermore,correct understanding of the MRI manifestations of IFI patients,combining clinical history and physical signs are the meaningful prerequisite for the diagnosis of IFI.