股骨头坏死的影像诊断与介入治疗研究  

The Study of Imaging Diagnosis and lnterventional Therapy of Avascular Necrosis of the Femoral Head.

作　　者：王永亮[1] 赵永生[1] 吕卓[1] 梁平[1] 杨海山[1] 高德义[2] 宫宝华[2] 徐莹[2] 

机构地区：[1]吉林大学中日联谊医院介入放射科,长春130031 [2]吉林省辽源市中心医院介入科

出　　处：《中华临床医学杂志》2007年第10期13-15,共3页Chinese Journal of Clinical Practical Medicine

摘　　要：目的研究股骨头坏死的CT及MRI诊断及分型，观察和评价介入治疗的效果和应用价值。方法本组216例，共计265侧肢体，进行CT、MRI诊断后介入治疗，其中男149例，女67例，年龄22—70岁，平均年龄53．7岁，诊断后采用股动脉穿刺插管灌注尿激酶的介入综合治疗。结果影像诊断结果，本组265个髋关节，CT检查164例，MRI检查190例，24例早期MRI呈斑点状、线条状长T1长T2信号改变。CT骨小梁结构紊乱，正常“星芒”征消失，出现斑点状骨硬化或小透光区。Й期54例，Ⅱ期88例，Ⅲ期58例，Ⅳ期24例，Ⅴ期2例。介入治疗结果，临床疼痛改善或消失者占91％，功能改善占82．2％，骨小梁再生12．1％，Ⅰ、Ⅱ期者治疗效果显著，Ⅳ、Ⅴ期者效果欠佳。结论CT、MRI提高了早期股骨头坏死的检出率，对介入治疗提供了可靠依据。介入留管灌注溶栓治疗能改善微循环，建立侧支和活血化淤功效，从而使坏死组织逐渐康复，对股骨头坏死治疗是一种具有显著疗效的方法。Objective To study CT and MRI diagnosis and classification about avascular necrosis of the femoral head, Observe and evaluate the effectiveness and value of interventional therapy. Methods In this group, 216 cases, for a total of 265 limbs, and interventional treatment after CT, MRI diagnosis, 149 men, 67 women, aged 22-70years, with an average age of 53,7years, After the diagnosis use femoral artery puncture infusion of urokinase interventional therapy. Results Diagnostic imaging results, the Group 265 hips, 164 cases CT, 190 cases MRI. 24 cases were spotty early MRI, the strips change long Tl and T2. CT trabecular bone structural disorder and normal＂Stelletta tenui Lindgren＂, Levy disappeared,or small spots and bone sclerosis subtypes. I phase 54 cases, IT phase 88 cases, lit phase 58 cases, IV Phase 24 cases, V Phase 2 cases. The results of interventional therapy, 91% of those who disappeared or improved clinical pain, functional improvements accounted for 82.2%, trabecular bone regeneration of 12.1%, I, lI significant treatment effect, IV, V phase were ineffective. Conclusion CT, MRI improved the detection rate of early necrosis of the femoral head, provided a reliable basis for the intervention. Interventional perfusion thrombolytic therapy can improve microcirculation, establish collateral and traditional efficacy, gradually recover necrotic tissues, which is a significant effect of the treatment method to avascular necrosis of the femoral head.

关 键 词：股骨头坏死 CT MRI诊断 介入治疗 

分 类 号：R381.8[医药卫生—医学寄生虫学]