早期成人股骨头缺血坏死的对比影像学诊断研究  

Comprehensive imaging diagnosis on the early avascular necrosis of femoral head in adult

作　　者：李秀红[1] 李雯[1] 李德勇[1] 许维亮[1] 

机构地区：[1]山东中医药大学第二附属医院放射科,山东济南250012

出　　处：《中国中西医结合影像学杂志》2008年第2期100-103,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的：探讨早期成人股骨头缺血坏死（FHN）的MRI、CT、单光子发射计算机体层摄影（SPECT）和DR 4种影像学检查方法之间的对应关系及其敏感性,建立早期诊断的影像学检查途径。方法：分析和总结22例30髋随访具有典型影像学表现的早期（ARCOⅠ～Ⅱ期）成人FHN患者的髋关节影像学资料。全部病例均行同期MRI、CT、SPECT、DR检查。结果：MRI 30髋出现“线样征”,其中15髋为“单线征”,15髋为“双线征”;CT上对应部位显示为较模糊的高密度硬化线14髋,硬化线下伴行低密度带7髋;高密度硬化斑点5髋;SPECT上股骨头呈环形和弧形放射性浓聚带23髋,DR上模糊硬化条带13髋。结论：MRI上“线样征”、CT上承重区高密度硬化线和硬化线下低密度带,SPECT上股骨头环形和弧形放射性浓聚带以及DR片上模糊硬化带相互对应为诊断早期FHN的特异性征象。综合比较对早期成人FHN诊断的敏感性MRI最高。Objective： To investigate the corresponding manifestations of MRI, CT, SPECT and DR in the early femoral head necrosis （FHN）in adult and to explore their sensitivity, thus to establish an imaging standard in early diagnosis of FHN. Methods： Twenty-two cases （30 hips） with early FHN in adult （ARCO Ⅰ - Ⅱ ） proved by follow-up study, or typical imaging manifestations were analyzed. All patients underwent MRI, CT, SPECT and DR in the same period. Results： ＂Line-like sign＂appeared on MRI in 30 of all affected hips, including single （15） and double lines （15）. They corresponded to the blurred high-density sclerosis line（14）on CT, two parallel lines consisting of a low density inner lines adjacent to a high-density line （7）, high-density sclerosis spots（5） ; roud or arc-like band of increased uptake of radioisotope on SPECT in 23 hips; band-like sclerosis on DR film in 13 hips. Conclusion： ＂line-like sign＂on MRI corresponds to the high-density sclerosis line around weight-supporting zone on CT, round or arc-like band of increased uptake of radioisotope in femoral neck or inferior part of femoral head on SPECT, and band-like burred sclerosis on DR. These manifestations are their specific signs in diagnosing early FHN , and MRI is superior to CT, SPECT and DR.

关 键 词：股骨头坏死 磁共振成像 体层摄影术 X线计算机 放射性核素显像 放射摄影术 

分 类 号：R681.8[医药卫生—骨科学] R445[医药卫生—外科学]