Background:

Currently, there is no consensus regarding the accuracy of magnetic resonance imaging (MRI) in the detection of acetabular chondral delamination (ACD) in patients with femoroacetabular impingement (FAI), and, correspondingly, the preoperative diagnosis of ACD remains challenging.

Hypothesis:

It was hypothesized that MRI would have relatively high accuracy in detecting ACD in patients with FAI.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

We retrospectively evaluated patients who attended the sports medicine clinic of our department and underwent arthroscopic surgery for the diagnosis of FAI between January 2018 and December 2020. All patients underwent preoperative 3.0-T MRI. ACD was evaluated by 2 raters on 3.0-T MRI scans, and interrater and intrarater reliability was assessed. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of MRI for diagnosis of ACD were calculated, using arthroscopic surgery as the standard.

Results:

A total of 233 patients (mean age, 37.4 years; 99 male and 134 female) were included in this study. The presence of ACD in 101 (43.3%) patients was confirmed during hip arthroscopy. The intraobserver reliability of both of the observers in detecting ACD using 3.0-T MRI scans was almost perfect (observer 1, kappa coefficient [κ] = 0.909 [95% CI, 0.854-0.964]; observer 2, κ = 0.937 [95% CI, 0.890-0.984]), and the interobserver reliability between the observers (κ = 0.801 [95% CI, 0.723-0.879]) was substantial. The overall sensitivity, specificity, PPV, and NPV of preoperative MRI to detect ACD were 83.7%, 82%, 74.2%, and 89.1%, respectively.

Conclusion:

It was found that 3.0-T MRI had a relatively high sensitivity, specificity, PPV, and NPV for diagnosis of ACD in patients with FAI and could be a reliable method of diagnosing ACD preoperatively.

中文翻译：

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磁共振成像诊断股骨髋臼撞击髋臼软骨分层的准确性

背景：

目前，关于磁共振成像（MRI）在检测股骨髋臼撞击（FAI）患者髋臼软骨分层（ACD）的准确性方面尚未达成共识，相应地，ACD的术前诊断仍然具有挑战性。

假设：

据推测，MRI 在检测 FAI 患者的 ACD 方面具有相对较高的准确性。

学习规划：

队列研究（诊断）；证据水平，2。

方法：

我们回顾性评估了 2018 年 1 月至 2020 年 12 月期间在我科运动医学诊所就诊并接受关节镜手术诊断 FAI 的患者。所有患者均接受了术前 3.0-T MRI 检查。ACD 由 2 名评估者对 3.0-T MRI 扫描进行评估，并评估评估者间和评估者内的可靠性。以关节镜手术为标准，计算MRI诊断ACD的敏感性、特异性、准确性、阳性​​预测值（PPV）和阴性预测值（NPV）。

结果：

本研究共纳入 233 名患者（平均年龄 37.4 岁；男性 99 名，女性 134 名）。髋关节镜检查证实 101 名 (43.3%) 患者存在 ACD。两位观察者在使用 3.0-T MRI 扫描检测 ACD 时的观察者内可靠性几乎是完美的（观察者 1，kappa 系数 [κ] = 0.909 [95% CI，0.854-0.964]；观察者 2，κ = 0.937 [95% CI，0.890-0.984]）和观察者之间的观察者间可靠性（κ = 0.801 [95% CI，0.723-0.879]）是显着的。术前MRI检测ACD的总体敏感性、特异性、PPV和NPV分别为83.7%、82%、74.2%和89.1%。

结论：

发现 3.0-T MRI 对 FAI 患者 ACD 的诊断具有较高的敏感性、特异性、PPV 和 NPV，可作为术前诊断 ACD 的可靠方法。