Page 234 - 磁共振成像2024年7期电子刊

磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7 综 述｜｜Reviews

坐骨股骨撞击综合征磁共振定量评估研究进展

*
刘玥，李红 ，万兵，田第娇，徐敬星，赵家源，王玟

作者单位 三峡大学附属仁和医院放射科，宜昌，443001
* 通信作者 李红，E-mail: 1741433022@qq.com
中图分类号 R445.2；R681.8 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.038
本文引用格式 刘玥, 李红, 万兵, 等. 坐骨股骨撞击综合征磁共振定量评估研究进展[J]. 磁共振成像, 2024, 15(7): 227-234.

[摘要] 坐骨股骨撞击综合征（ischiofemoral impingement syndrome, IFI）是一种比预期更常见的髋关节外撞击综合征，临床表
现缺乏特异性，极易与梨状肌综合征、腰椎间盘突出症等混淆。MRI 既可测量与 IFI 相关的径线、角度，还能定量或半定量评
估相关骨骼肌的面积、体积及信号，已成为 IFI的首选检查方法。运动范围 MRI有助于减少体位因素对解剖形态学参数的影响，
提高了评估 IFI的敏感性和准确性；动态 MRI和三维 MRI的联合应用，能在获取实际运动过程中 IFI相关解剖结构功能信息的同
时，更真实地反映解剖结构在三维空间中的位置关系，将进一步提高诊断的全面性和准确性；功能MRI（functional MRI, fMRI）
可通过测量水分子扩散和微循环灌注、脂肪浸润、物质代谢等股方肌、髋外展肌的微观水平定量指标，使 IFI 的精准诊断及预
测、运动功能监测等成为可能，有望成为 IFI 临床诊疗新的研究方向。本文将阐述多种 MRI 和 fMRI 技术在定量评估 IFI 的应用
研究，总结其优点及缺点，为临床全面、精准评估IFI的发生、进展及转归提供参考。
[关键词] 坐骨股骨撞击综合征；磁共振成像；功能磁共振成像；动态三维成像；骨骼肌
Research progress on quantitative evaluation of ischiofemoral impingement syndrome by magnetic
resonance imaging

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LIU Yue, LI Hong , WAN Bing, TIAN Dijiao, XU Jingxing, ZHAO Jiayuan, WANG Wen
Department of Radiology, Renhe Hospital affiliated to China Three Gorges University, Yichang 443001, China
* Correspondence to LI H, E-mail: 1741433022@qq.com
Received 1 Apr 2024, Accepted 26 Jun 2024; DOI 10.12015/issn.1674-8034.2024.07.038
ACKNOWLEDGMENTS 2022 Hubei Provincial Department of Education Scientific Research Plan Project (No: B2022032).
Cite this article as LIU Y, LI H, WAN B, et al. Research progress on quantitative evaluation of ischiofemoral impingement syndrome by
magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2024, 15(7): 227-234.
Abstract Ischiofemoral impingement syndrome (IFI) is a type of extra-articular hip impingement that is more common than
anticipated, the lack of specificity in clinical presentation makes, it easily confused with other conditions like piriformis syndrome and
lumbar disc herniation. MRI is capable of measuring dimensions and angles associated with IFI and can also provide quantitative or
semi-quantitative assessments of the size and signal intensity of the relevant skeletal muscles, making it the preferred diagnostic modality
for IFI. Range of motion MRI helps to reduce the impact of positional factors on morphological parameters, improving the sensitivity and
accuracy of IFI diagnosis; the combined application of dynamic MRI and three-dimensional MRI can obtain functional information of
IFI-related anatomical structures during actual movement, while more truly reflecting the spatial relationship of anatomical structures in
three-dimensional space, which will further improve the comprehensiveness and accuracy of diagnosis. Functional MRI (fMRI) can
measure the water molecule diffusion, microcirculation status, the extent of fat infiltration, muscle fiber orientation, and metabolic levels
of the quadratus femoris and hip abductor muscles, making precise diagnosis and prediction of IFI, as well as monitoring of movement
function, possible, and is expected to become a new research direction for the clinical diagnosis and treatment of IFI. This review will
elaborate on the application of various MRI and fMRI technologies in the quantitative assessment of IFI, summarize their advantages and
disadvantages, and provide references for the comprehensive and precise assessment of the occurrence, progression, and outcome of IFI
using multi-parameter joint application of MRI and fMRI.
Key words ischiofemoral impingement syndrome; magnetic resonance imaging; functional magnetic resonance imaging; dynamic
three-dimensional imaging; skeletal muscle

0 引言 征，继发髋部伸展受限时腰椎椎小关节压力增加，可
坐骨股骨撞击综合征（ischiofemoral impingement 发生髋-脊柱综合征。
syndrome, IFI）于 2009 年由 TORRIANI 等 提出 ，定 目前主要根据临床表现及 MRI 典型征象诊断
[1]
义为坐骨结节-股骨小转子间隙（ischiofemoral space, IFI。临床将股骨撞击试验和大跨步行走试验用于诊
[2]
IFS）和股方肌间隙（quadratus femoris space, QFS）狭 断 IFI；MARAŞ ÖZDEMIR 等 认为近期提出的两步
窄导致股方肌受到邻近坐骨结节及股骨小转子、腘 激发试验引起的臀后部疼痛与 IFS 狭窄有关。MRI
绳肌肌腱及髂腰肌肌腱摩擦引起的急、慢性损伤的 可获取 IFI 相关径线、角度及骨骼肌面积、体积等定
临床综合征。股方肌受压、水肿刺激坐骨神经引起 量参数，并依据信号差异对骨骼肌水肿、脂肪浸润程
髋关节弹响、疼痛，坐骨神经卡压则出现臀深综合 度进行半定量分级与评分，已成为 IFI 的首选检查方

收稿日期 2024-04-01 接受日期 2024-06-26
基金项目 2022年度湖北省教育厅科学研究计划项目（编号：B2022032）

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