股骨头坏死骨髓水肿与MRI分期相关性分析  

Analysis of Correlation Between Bone Marrow Edema and MRI Staging in Femoral Head Necrosis

作　　者：高振华[1] 马玲[1] 臧建[2] 孟悛非[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]广东省深圳市第三人民医院放射科,广东深圳518020

出　　处：《中国CT和MRI杂志》2012年第1期1-3,共3页Chinese Journal of CT and MRI

基　　金：广东省医学科学技术研究基金项目(项目编号:B2010073)

摘　　要：目的探讨股骨头坏死骨髓水肿与MRI分期的关系,进一步提高骨髓水肿在股骨头坏死中临床意义的认识。方法搜集经病理或临床随访证实的60例106髋成人股骨头坏死MRI资料并根据股骨头外形、坏死区信号和关节软骨表现进行相应MRI分期:Ⅰ期(坏死股骨头外形正常且坏死区呈单纯脂肪样信号)、Ⅱ期(坏死股骨头外形正常且坏死区呈脂肪肉芽组织样混杂信号)、Ⅲ期(坏死股骨头轻度塌陷但未出现关节软骨碎裂)和Ⅳ期(坏死股骨头明显塌陷且出现关节退行性变征象),对不同MRI分期中骨髓水肿出现率进行观察总结。结果股骨头坏死Ⅰ期骨髓水肿出现率(7/24髋)低于Ⅱ期(30/40髋)(P<0.01),Ⅰ期和Ⅱ期骨髓水肿出现率均低于Ⅲ期(19/19髋)和Ⅳ期(23/23髋)(P<0.01),Ⅲ期和Ⅳ期骨髓水肿出现率相当(P>0.05)。结论股骨头坏死的MRI分期不同,其骨髓水肿的出现率不同,可作为反映疾病进程的指标之一。Objective To study the correlation between bone marrow edema（BME） and MRI staging in order to further enhance understanding of the clinical significance of BME in femoral head necrosis（FHN）.Methods MRI data of sixty patients（106 hips） with FHN proved by clinical follow-up or pathology were analyzed respectively and divided into four different stages according to femoral head shape,signals of necrotic area,and articular cartilage.StageⅠwas defined as normal appearance of necrotic head and simply fat-like signal of necrostic area.StageⅡas normal appearance of femoral head and granulation-tissue mixed signal of necrotic area.StageⅢ as mild collapse of femoral head but no fragmentation of the articular cartilage,and Stage Ⅳ as obvious collapse of femoral head and emergence of significant signs of joint degeneration.The occurrence rate of BME in different MRI stages of FHN were summarized.Results The occurance rate of BME（7/24 hips） in stageⅠ was greater than that in stageⅡ（30/40 hips）（p0.01）,which were both less than that in stage Ⅲ（19/19 hip） and stage Ⅳ（23/23 hips）（p0.01）.The occurance rate of BME in stage Ⅲ and was equal to that in stage Ⅳ（P0.05）.Conclusion The different rates of emergence of BME,which appears in different MRI stages of FHN,can be used as one of indicators of disease progression.

关 键 词：骨坏死 股骨头 骨髓水肿 磁共振成像 分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.8[医药卫生—诊断学]