严重急性呼吸综合征康复患者骨坏死与骨髓转化的MRI研究  

The MR Imaging of Osteonecrosis and Marrow Conversion in Patients with Severe Acute Respiratory Syndrome Treated with Steroids

作　　者：牛金亮[1] 孔祥泉[1] 冯敢生[1] 韩萍[1] 王峻[2] 苏晋生[3] 谢维娜[2] 

机构地区：[1]华中科技大学同济医学院协和医院 [2]山西医科大学第二医院影像科 [3]山西省太原市中心医院

出　　处：《临床放射学杂志》2006年第4期357-360,共4页Journal of Clinical Radiology

摘　　要：目的采用MRI观察严重急性呼吸综合征(SARS)康复患者骨缺血坏死和股骨骨髓转化,分析SARS骨坏死的MRI特征及骨髓转化的意义。资料与方法112例SARS患者行股骨MRI检查,检查序列为SET1WI及短时间反转恢复序列(STIR)。骨髓转化系数(MCI)值为T1WI干骺端信号强度与大转子信号强度的比值。结果112例SARS患者中23例发生骨坏死,双侧股骨头坏死13例,双侧股骨头坏死合并双侧股骨干远端骨梗死1例,单侧股骨头坏死2例,干骺端骨坏死6例,双侧膝关节骨坏死1例,MRI显示坏死区均含黄骨髓。21例无骨髓水肿的骨坏死患者MCI值高于年龄相似的无骨坏死患者,差异具有显著意义(P<0.05),两组激素的总量及日平均量差异显著(P<0.05)。结论SARS康复患者骨坏死发生于黄骨髓含量高的部位,MCI对骨坏死的预测有重要意义。Objective To observe the MR imaging of osteonecrosis and marrow conversion in patients with severe acute respiratory syndrome treated with steroids, to analyze the feature of osteonecrosis and the significance of marrow conversion. Materials and Methods MR scanning was performed in 112 patients with SAPS. MR imaging of femur was obtained by the short time inversion recovery and T1 weighted spin echo technique. The marrow conversion index（MCI） was the ratio of the marrow signal intensity of the proximal femoral metaphysis （SM） to that of the greater trochanter （ST）. The marrow conversion indes = （SM/ST）×100. Results Among 112 patients, there were 23 cases with osteonecrosis, bilateral femoral head （ n = 13）, bilateral femoral head and distal diaphysis （ n = 1 ）, metaphysis （ n = 6）, unilateral femoral head （ n = 1 ）, double knee （ n = 1 ）. The lesion of osteonecrosis was located in the site of yellow marrow. 21 cases of osteonecrosis without marrow edema had higher value of MCI than that of age matched cases without osteonecresis. There was statistical difference of statistical in the two groups （P 〈 0.05）, meanwhile, there was different total and average dose of steroids respectively （ P 〈 0.05 ）. Conclusion The site of osteonecresis in patients with SARS is located in the area of yellow marrow. The value of MCI is helpful in evaluating the risk of osteonecrosis.

关 键 词：严重急性呼吸综合征 骨坏死 骨髓转化 磁共振成像 

分 类 号：R511.9[医药卫生—内科学]