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CT of the hips in the investigation of protrusio acetabuli in Marfan syndrome. A case control study.

Lundby R, Kirkhus E, Rand-Hendriksen S, Hald J, Pripp AH, Smith HJ - Eur Radiol (2011)

Bottom Line: A slight but significant gender difference was found in Ghent positive persons only.The alternative method did not differentiate between the groups with respect to PA, but showed a significant difference between genders.PA was found significantly more often in MFS persons than in controls.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, University of Oslo, Oslo, Norway. rigmor.lundby@medisin.uio.no

ABSTRACT

Objectives: To establish the prevalence of protrusio acetabuli (PA) in adults fulfilling the Ghent criteria for Marfan syndrome (MFS), and in a normal adult population.

Methods: 105 adults with probable MFS and 107 controls were included. CT of the hips was obtained. A qualitative assessment of PA was performed. A new method for estimating the degree of PA was introduced with measurement of the parameter CWD (circle-wall distance). Results were compared to an alternative method based on MRI [1].

Results: 87 of the study group fulfilled the Ghent criteria of MFS (Ghent positives), and 18 did not (Ghent negatives). PA was diagnosed qualitatively in 74.7% of Ghent positive persons, in 27.8% of Ghent negative persons, and in 3.7% of the controls. CWD was significantly different between the three groups (p < 0.001). A slight but significant gender difference was found in Ghent positive persons only. The alternative method did not differentiate between the groups with respect to PA, but showed a significant difference between genders.

Conclusions: PA was found significantly more often in MFS persons than in controls. Our method was found to be robust and highly reproducible, giving a direct measurement of pelvic protrusion irrespective of pelvic shape.

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Related in: MedlinePlus

ROC curve of CWD as a marker of MFS when comparing Ghent positive patients and controls
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Fig3: ROC curve of CWD as a marker of MFS when comparing Ghent positive patients and controls

Mentions: Quantitative assessment of acetabular protrusion using the 10 cm circle was possible in all study persons and controls. Measurement of CWD showed statistically significant differences between the three groups (Table 2). The median CWD was 3 mm (range 0.0–9.0 mm) in Ghent positive persons, 0 mm (range -0.5–5.0 mm) in Ghent negative persons, and 0 mm (range -3.0–2.0 mm) in controls. ROC analysis of CWD vs. qualitative diagnosis of PA showed an area under the curve of 0.99 (95% CI 0.98–1.0); a CWD cut-off value of 1.25 mm resulted in a sensitivity and specificity for PA of 95.5% and 97.6%, respectively. ROC analysis of CWD in differentiating MFS from controls showed a sensitivity and specificity in diagnosing MFS of 68.8% and 97.2%, respectively, when using a CWD cut-off value of 1.25 mm (Fig. 3).Fig. 3


CT of the hips in the investigation of protrusio acetabuli in Marfan syndrome. A case control study.

Lundby R, Kirkhus E, Rand-Hendriksen S, Hald J, Pripp AH, Smith HJ - Eur Radiol (2011)

ROC curve of CWD as a marker of MFS when comparing Ghent positive patients and controls
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101339&req=5

Fig3: ROC curve of CWD as a marker of MFS when comparing Ghent positive patients and controls
Mentions: Quantitative assessment of acetabular protrusion using the 10 cm circle was possible in all study persons and controls. Measurement of CWD showed statistically significant differences between the three groups (Table 2). The median CWD was 3 mm (range 0.0–9.0 mm) in Ghent positive persons, 0 mm (range -0.5–5.0 mm) in Ghent negative persons, and 0 mm (range -3.0–2.0 mm) in controls. ROC analysis of CWD vs. qualitative diagnosis of PA showed an area under the curve of 0.99 (95% CI 0.98–1.0); a CWD cut-off value of 1.25 mm resulted in a sensitivity and specificity for PA of 95.5% and 97.6%, respectively. ROC analysis of CWD in differentiating MFS from controls showed a sensitivity and specificity in diagnosing MFS of 68.8% and 97.2%, respectively, when using a CWD cut-off value of 1.25 mm (Fig. 3).Fig. 3

Bottom Line: A slight but significant gender difference was found in Ghent positive persons only.The alternative method did not differentiate between the groups with respect to PA, but showed a significant difference between genders.PA was found significantly more often in MFS persons than in controls.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, University of Oslo, Oslo, Norway. rigmor.lundby@medisin.uio.no

ABSTRACT

Objectives: To establish the prevalence of protrusio acetabuli (PA) in adults fulfilling the Ghent criteria for Marfan syndrome (MFS), and in a normal adult population.

Methods: 105 adults with probable MFS and 107 controls were included. CT of the hips was obtained. A qualitative assessment of PA was performed. A new method for estimating the degree of PA was introduced with measurement of the parameter CWD (circle-wall distance). Results were compared to an alternative method based on MRI [1].

Results: 87 of the study group fulfilled the Ghent criteria of MFS (Ghent positives), and 18 did not (Ghent negatives). PA was diagnosed qualitatively in 74.7% of Ghent positive persons, in 27.8% of Ghent negative persons, and in 3.7% of the controls. CWD was significantly different between the three groups (p < 0.001). A slight but significant gender difference was found in Ghent positive persons only. The alternative method did not differentiate between the groups with respect to PA, but showed a significant difference between genders.

Conclusions: PA was found significantly more often in MFS persons than in controls. Our method was found to be robust and highly reproducible, giving a direct measurement of pelvic protrusion irrespective of pelvic shape.

Show MeSH
Related in: MedlinePlus