Purpose To introduce the delamination width and delamination length for the quantitative description of the delamination between cartilage on MRI, and to determine the diagnostic value for acetabular cartilage delamination (ACD). Methods Data between January 2018 to December 2020 was reviewed. Patients diagnosed femoroacetabular impingement syndrome (FAIS) and underwent hip arthroscopy were included. Exclusion criteria were prior hip surgery and concomitant hip conditions. The delamination width and delamination length were measured at the coronal slice on magnetic resonance imaging (MRI) where the low-signal area on the fat-saturated proton density (FSPD) sequence was most apparent between the cartilage. The delamination width was measured along the direction of the radial line originating from the center of the femoral head. The delamination length was measured as the curve across the endpoints of delamination. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of these measurements. Results A total of 176 patients were included, with 69 (39.2%) patients diagnosed with ACD under arthroscopy. Patients with ACD demonstrated significant larger delamination width and delamination length compared to patients without ACD (all with P < 0.001). The area under curve (AUC) for delamination width and length predicting ACD was 0.8677 (95% CI: 0.8113 to 0.9240) and 0.8113 (95% CI: 0.7528 to 0.8698), respectively. The cut off value of delamination width was 0.95 mm, with the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to be 89.9%, 74.8%, 70.0%, and 91.9%, respectively. The cut off value of delamination length was 2.80 mm, with the sensitivity, specificity, PPV, and NPV to be 43.0%, 94.2%, 90.2%, and 48.4%, respectively. Male sex and BMI were positively associated with delamination width and delamination length (all with P < 0.05). Conclusion The delamination width and delamination length demonstrated good diagnostic value for ACD. Male sex and BMI were positively associated with these measurements. ACD may occur when the delamination width exceeds 0.95 mm and delamination length exceeds 2.80 mm in patients with FAIS. Level of evidence Level III. Cohort study.

Quantitative measurements for acetabular cartilage delamination on MRI

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2026年5月26日

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Yichuan Zhu,
Guanying Gao,
Yan Xu

摘要

Purpose

To introduce the delamination width and delamination length for the quantitative description of the delamination between cartilage on MRI, and to determine the diagnostic value for acetabular cartilage delamination (ACD).

Methods

Data between January 2018 to December 2020 was reviewed. Patients diagnosed femoroacetabular impingement syndrome (FAIS) and underwent hip arthroscopy were included. Exclusion criteria were prior hip surgery and concomitant hip conditions. The delamination width and delamination length were measured at the coronal slice on magnetic resonance imaging (MRI) where the low-signal area on the fat-saturated proton density (FSPD) sequence was most apparent between the cartilage. The delamination width was measured along the direction of the radial line originating from the center of the femoral head. The delamination length was measured as the curve across the endpoints of delamination. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of these measurements.

Results

A total of 176 patients were included, with 69 (39.2%) patients diagnosed with ACD under arthroscopy. Patients with ACD demonstrated significant larger delamination width and delamination length compared to patients without ACD (all with P < 0.001). The area under curve (AUC) for delamination width and length predicting ACD was 0.8677 (95% CI: 0.8113 to 0.9240) and 0.8113 (95% CI: 0.7528 to 0.8698), respectively. The cut off value of delamination width was 0.95 mm, with the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to be 89.9%, 74.8%, 70.0%, and 91.9%, respectively. The cut off value of delamination length was 2.80 mm, with the sensitivity, specificity, PPV, and NPV to be 43.0%, 94.2%, 90.2%, and 48.4%, respectively. Male sex and BMI were positively associated with delamination width and delamination length (all with P < 0.05).

Conclusion

The delamination width and delamination length demonstrated good diagnostic value for ACD. Male sex and BMI were positively associated with these measurements. ACD may occur when the delamination width exceeds 0.95 mm and delamination length exceeds 2.80 mm in patients with FAIS.

Level of evidence

Level III. Cohort study.