股骨髋臼撞击综合征的影像学研究  

Research of imageology for femoro-acetabular impingement

作　　者：林崇明[1] 刘卓[1] 谷贵山 朱东[2] 

机构地区：[1]解放军第174医院骨二区,厦门361003 [2]吉林大学附属第一医院骨关节一科,长春130021

出　　处：《中国矫形外科杂志》2010年第3期205-207,共3页Orthopedic Journal of China

摘　　要：[目的]探讨早期诊断股骨髋臼撞击综合征(femoro-acetabular impingement,FAI)的标准,FAI患者在疾病进展的各阶段的16排螺旋CT平扫、三维重建以及磁共振等影像学表现,以及上述影像学检查结果在疑似患有FAI的患者中与其它疾病相鉴别与指导临床治疗的重要性。[方法]选取6例FAI患者,均为男性,所有患者均具有腹股沟区间断性疼痛病史,休息后疼痛能够得到明显或完全缓解,且髋关节前撞击试验和(或)后撞击试验阳性。对这些患者行骨盆正位片、髋关节16排螺旋CT平扫及三维重建,髋关节磁共振成像平扫检查。[结果]骨盆正位片检查结果可显示出大部分的先天解剖学异常;16排螺旋CT平扫及三维重建结果可全方位清晰显示髋关节病变。磁共振平扫结果显示中后期FAI患者髋关节的炎性改变。[结论]标准的骨盆正位片上可发现FAI患者若干先天解剖学异常再结合患者典型的症状和体征即可早期正确诊断;髋关节多层螺旋CT及三维重建检查,可发现如股骨头颈连接处的前外侧偏移量减低等异常,为手术方案提供直接参考;中后期的FAI患者行髋关节MRI检查,可发现髋臼盂唇的裂伤或者软骨变性,为手术治疗髋臼唇撕裂提供确切证据;髋关节MRI检查结果可将本病与早期股骨头缺血性坏死相鉴别。[Objective]To probe the standard of early diagnosis of femoro-acetabular impingement（FAI）,and the imageological appearance of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction,and MRI of progression of FAI patients.And to approach the significance of using the imageology result to identity doubtful FAI patients with other patients.[Methods]Six FAI patients were enrolled.CT and MRI noncontrast enhanced scan and CT three-dimensional reconstruction were performed to assess the hip joint.The CT scan was performed on the GE Lightspeed 16 row spiral at 1.25 mm slice reconstruction.The MRI scan was performed on the Siemens Avanto 1.5T supraconduction magnetic resonance meter.The CT and MRI scan included the acetabulum to the lesser trochanters.[Results]The results of DR of pelvis orthophoria discovered subtotal congenital anatomic abnormality of hip.The result of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction discovered total cong...更多enital anatomic abnormality of hip.The result of MRI noncontrast enhanced scan discovered phlegmasia of hip joint of midanaphase patients of FAI.[Conclusion]Non-buninoid femoral head,hyper-deep of hip,acetabular anteversion and hypsokinesis,and typical sings and symptoms lead to early and exactitude diagnosis.The results of 16 row spiral CT three-dimensional reconstruction and MRI can provid straight reference operation schedule;The result of MRI noncontrast enhanced scan can detect FAI with early avascular necrosis of the femoral head.

关 键 词：股骨髋臼撞击综合征 骨盆正位片 16排螺旋CT 磁共振成像 

分 类 号：R681.8[医药卫生—骨科学]