激素性股骨头缺血坏死的影像学诊断价值  

Usefulness of Imaging Techniques in Diagnosis of Corticosteroid-induced Avascular Necrosis of Femoral Head

作　　者：朱娟[1] 龙莉玲[1] 肖增明[2] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021 [2]广西医科大学第一附属医院创伤脊骨科,广西南宁530021

出　　处：《实用放射学杂志》2004年第11期1003-1006,共4页Journal of Practical Radiology

基　　金：广西自然基金资助项目 (编号 :桂科字 0 1 350 4 4 )

摘　　要：目的　研究医源性股骨头缺血性坏死的影像学诊断价值。方法　回顾性分析 2 7个长期大量激素治疗后引起股骨头缺血性坏死的病例。男 11例 ,女 16例 ,年龄 2 0～ 46岁 ,平均 3 5 .6岁 ,病程 1～ 5年。口服强的松最大剂量 ( 60～ 2 5 )mg/d ,用药时间6个月～ 5年 ,股骨头缺血性坏死出现时间为用药后 3个月～ 2年。 2 0例行X线检查 ,15例行MRI检查 ,均行X线、MRI检查的有10例。 8例行CT检查 ,8例经手术病理证实。结果　X线平片诊断早期ANFH 6例 ,7个股骨头 ,CT诊断 7例 ,11个股骨头。MRI诊断 15例 ,2 1个股骨头。MRI早期诊断ANFH的 2 1个股骨头中 ,19个出现线样低信号 ,其中表现为“单线征”6个 ,“双线征”13个。结论　MRI“线样征”是诊断早期缺血坏死的特征性表现。MRI诊断早期ANFH的阳性率高于X线、CT。Objective To evaluate the usefulness of imging techniques in diagnosis of corticosteroid-induced avascular necrosis of the femoral head(ANFH).Methods Twenty seven patients with avascular necrosis of the femoral head due to long-term corticosteriod treatment were analysed retrospectively.There were 16 femal and 11 male,ranged in age from 20 to 46 years(mean age 35.6 years).The course of disease was 1～5 years.The administration of corticoid orally was 60～25 mg/d taken on 6 months to 5 years.ANFH was appeared 3 months to 2 years after the administration of corticoid.The imaging examinations included radiography in 20 cases,MRI in 15 cases,both radiography and MRI in 10 cases and CT in 8 cases.8 cases were confirmed by operation and pathology.Results 7 femoral heads in 6 cases with early-ANFH were diagnosed by X-ray,21 femoral heads in 15 cases with early-ANFH were diagnosed by MRI and 11 femoral heads in 7 cases were by CT,19 femoral heads showed a typical “line sign”on MRI.Conclusion The “line sign” on MRI is regarded as the characteristic finding in early-ANFH.MRI is the most sensitive method in the early-diagnosis of the corticosteroid-induced ANFH and it can provide important evidence for clinical management.

关 键 词：股骨头缺血性坏死 ANFH 影像学诊断 MRI检查 早期诊断 激素性股骨头缺血坏死 MRI诊断 X线 手术病理 用药后 

分 类 号：R681[医药卫生—骨科学] R743[医药卫生—外科学]