与三维计算机断层扫描相比，x线片上的横向中心边缘角测量被低估了

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-02-01 DOI:10.1016/j.asmr.2024.101005

Julio Nerys-Figueroa B.S. , Ady H. Kahana-Rojkind M.D. , Ali Parsa M.D. , David Maldonado M.D. , Roger Quesada-Jimenez M.D. , Benjamin G. Domb M.D.

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引用次数: 0

摘要

目的：确定以股骨头（FHs）作为解剖水平测量外侧中心边缘角（LCEA）与底、髋臼泪滴和坐骨结节（ITs）相比是否有显著差异，并通过与商用软件的计算机断层扫描（CT）进行比较，确定其准确性。方法纳入2019年6月至2020年5月术前仰卧位骨盆前后位x线片和CT扫描的患者并进行回顾性分析。在术前仰卧位骨盆前后位x线片上测量LCEA，每髋4次，采用4种方法。将测量LCEA的4个解剖视界相互比较，确定具有统计学意义的差异。在12点钟位置的CT扫描中测量的LCEA用于比较和确定x线片的LCEA准确性。结果96例患者（100髋）符合纳入标准。女性62例（65%），平均年龄35.2±15岁。CT上LCEA的平均值为32.2，x线上4个解剖层位的平均值为31.1 (P <；措施)。使用FHs获得CT扫描与x线的最小平均差值（2.3±2.4）。FHs与ITs的平均差异较小（1.0±0.8）。结论在本研究中，与CT扫描相比，x线测量低估了LCEA。在x线片上使用FHs作为解剖水平比使用髋臼泪滴、ITs或地板更准确地测量LCEA。虽然这种差异在统计学上是显著的，但在临床上不太可能是显著的。髋臼覆盖范围评估是诊断和管理髋关节病变的重要方面。其中一种方法是LCEA测量，这是基于髋关节的放射学分析。比较使用不同视界和日益复杂的成像方式的测量结果，为指导临床决策提供最准确的信息是很重要的。

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The Measurement of the Lateral Center-Edge Angle Is Underestimated on Radiographs Compared With 3-Dimensional Computed Tomography

Purpose

To determine if there is a significant difference using femoral heads (FHs) as an anatomic horizon when measuring the lateral center-edge angle (LCEA) compared to floor, acetabular teardrops, and ischial tuberosities (ITs) and to determine their accuracy by comparing to a computed tomography (CT) scan with commercially available software.

Methods

Between June 2019 and May 2020, patients with preoperative supine anteroposterior pelvis radiographs and CT scans were included and retrospectively analyzed. The LCEA was measured on all preoperative supine anteroposterior pelvis radiographs 4 times per hip, using the 4 methods. The 4 anatomic horizons used to measure LCEA were compared to each other to determine statistically significant difference. The LCEA measured in the CT scan at the 12-o’clock position was used to compare and determine radiographs’ LCEA accuracy.

Results

Ninety-six patients (100 hips) met the inclusion criteria. Sixty-two were women (65%), and the mean age was 35.2 ± 15 years. The mean value for LCEA in CT was 32.2 and 31.1 for the 4 anatomic horizons on x-ray (P < .001). The lowest mean difference between CT scan and x-ray was obtained using the FHs (2.3 ± 2.4). Less mean difference was obtained between FHs and ITs (1.0 ± 0.8).

Conclusions

In this study, radiographic measurements underestimated LCEA compared with those from CT scans. Using the FHs as an anatomic horizon on radiographs was a more accurate method to measure LCEA than using acetabular teardrops, ITs, or floor. While this difference is statistically significant, it is not likely to be clinically significant.

Clinical Relevance

Assessment of acetabular coverage is an essential aspect of diagnosing and managing hip pathologies. One of the methods used for this is the LCEA measurement, which is based on a radiographic analysis of the hip joint. It is important to compare the measurements using different horizons and increasingly sophisticated imaging modalities to provide the most accurate information to guide clinical decision making.

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