股骨头缺血坏死的分期及早期影像诊断  

Grading of Avascular Necrosis of Femoral Head and Early Imaging Diagnosis

作　　者：郭章留 

机构地区：[1]内黄县人民医院,内黄县456300

出　　处：《医药论坛杂志》2008年第7期43-45,47,共4页Journal of Medical Forum

摘　　要：目的研究股骨头缺血坏死(ANFH)的分期及早期影像学诊断。方法86例双侧股骨头行X线平片、CT及低场MRI检查,对其影像学改变进行分期对照。结果全部患者X线平片诊断早期ANFH共126个部位,其中I期占58个,X线表现为骨质疏松及骨硬化,II期68个,表现为骨硬化和囊状低落度区。CT发现早期ANFH76例共108个部位,其中I期占44个,表现为组成骨小梁星芒结构消失,骨质疏松变和骨硬化,II期34个,表现为囊状低密度区及骨硬化,Ⅲ期30个,以新月征为特点。低场MRI仅发现68例98个部位,I期45个,表现为斑点状T1WI低或高信号,Ⅱ期33个,表现为T1WI及长TE梯度回波(GRL)序列呈不规则低等高信号。Ⅲ期20个,在T1WI及GRL序列呈片状低信号,并可见高信号环绕。三者比较差异较大,意义显著。结论CT及低场MRI可早期显示ANFH病变,而低场MRI对ANFH的敏感性及诊断价值高于X线平片及CT。Objective To study the staging and early immaging diagnosis of avascular necro- sis of the femoral head （ANFH）. Methods X - ray, CT and low - field MRI were conducted and grading was performed in bilateral femoral head of 86 cases, Rank sum H test and sensitivity were completed. Results The entire cases were diagnosed as early ANFH by X - ray film in 126 places, Stage Ⅰ showed osteoporosis and osteosclerosis in 58 places, Stage Ⅱ showed osteosclerosis and cystic hyalomere in 68 places. 76 cases of early ANFH were discovered by CT in 108 places,Stage Ⅰ stelliform sign distortion and osteoporosis and osteosclerosis in 44 places, StageII showed meniscus sign is 34 places. Low - field MRI displayed only 68 cases （98 places ） of early ANFH, Stage I displayed the macular shape low or high signal intensity on Tl weighted and Grl image in 45 places. Stage Ⅱ displayed the irregular shape low or equal or high signal on T1 weighted and GRL image in 33 places. Stage m displayed the flaky low signal and curve high signal on T1 weighted and GRL image in 20 places. Rank sum H test and sensitivity compare were striking. Conclusion CT snd low -field MRI could exactly display early ANFH Sensitivity and diagnostic value of low - filed MRI is superior to CT and X - ray film.

关 键 词：股骨头坏死 体层摄影术 X线计算机 磁共振成像 

分 类 号：R816.8[医药卫生—放射医学]