股骨头缺血坏死合并股骨颈疝窝的CT诊断  

CT Diagnosis of Avascular Necrosis of the Femoral Head Coexist with Herniation Pits of the Femoral Neck

作　　者：巩孝文 王存利 黄振国[2] 胡立斌[2] 

机构地区：[1]包头市第三医院放射科,内蒙古包头014014 [2]中日友好医院放射科,内蒙古北京100029

出　　处：《内蒙古医学杂志》2012年第2期160-162,F0004,共4页Inner Mongolia Medical Journal

摘　　要：目的:分析股骨头缺血坏死(avascular necrosis of the femoral head,ANFH)合并股骨颈疝窝的CT表现,提高诊断和鉴别诊断水平。方法:回顾性分析15例有典型影像学表现的ANFH合并股骨颈疝窝CT表现。结果:15例中9例为双侧ANFH,6例为单侧ANFH,共累及24侧股骨头;2例股骨颈疝窝为双侧,余13例为单侧。股骨颈疝窝病灶均位于股骨头颈交界区前外侧皮层下,呈圆形、卵圆形或轻度分叶,病灶最大径均小于1 cm,病灶中心呈低密度,周围均有明显环状硬化。ANFH病灶均大于3 cm,病灶均累及股骨头前部外上方承重区,与正常区相比病灶中心呈等密度15侧、低密度7侧、高密度2侧,18侧ANFH病灶周围呈单纯线状高密度硬化带分隔病灶与正常区,余6侧于高密度硬化带内侧伴行线状低密度影。结论:ANFH和股骨颈疝窝均有特定的发生部位和CT表现,可依据病灶位置、大小、形态和密度对两者鉴别及诊断ANFH合并股骨颈疝窝。Objective：To improve the level of diagnosis and differential diagnosis by analysing the CT features of avascular necrosis of the femoral head（ANFH）coexist with herniation pits of the femoral neck.Methods： CT findings of 15 patients with ANFH coexist with herniation pits of the femoral neck were analyzed retrospectively.Results： 24 femoral heads were involved in 15 patients with ANFH,of which bilateral femoral heads were involved in 9 cases.2 of 15 cases of herniation pits of the femoral neck involved bilateral femoral necks.The lesions of herniation pits of the femoral neck were round,oval or lobular,located in the superior lateral quadrant of the femoral head-neck junction.Lesions were less than 10 mm in greatest diameter.CT revealed radiolucent lesions surrounded by a thin clear sclerotic rim.ANFH involved the anterosuperior aspect of the femoral head and lesion was more than 3cm in all cases.Compared with extralesional area necrotic area appeared equidensity in 15 hips,lower density in 7 hips and higher density in 2 hips.In 18 hips a sclerotic line and in 6 hips two parallel lines consisting of a lowdensity inner line adjacent to a high-density line were seen between necrotic and extralesional area.Conclusion： ANFH and herniation pit of femoral neck have special location and CT appearances.On basis of its characteristic location,morphologic findings,size and density allow to make differential diagnosis and diagnose ANFH coexist with herniation pit of femoral neck.

关 键 词：股骨头缺血坏死 疝 股骨颈 体层摄影 X线计算机 

分 类 号：R684[医药卫生—骨科学] R612[医药卫生—外科学]