SPECT-CT评价股骨颈骨折后股骨头血供的变化  

Semi-quantitative assessment of the perfusion in femoral head after femoral neck fracture by SPECT-CT

作　　者：申锋[1] 阎作勤[1] 郭常安[1] 费腾[1] 潘建锋[1] 刘嘉[1] 李朔[1] 石洪成[2] 顾宇参[2] 陈曙光[2] 

机构地区：[1]复旦大学附属中山医院骨科,200032 [2]复旦大学附属中山医院核医学科,200032

出　　处：《中华关节外科杂志（电子版）》2012年第2期6-9,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家自然科学基金项目(81171671);上海市科委医学引导类基金资助项目(10411962500)

摘　　要：目的利用SPECT-CT观察不同分型股骨颈骨折后股骨头血供的变化和股骨头不同部位血供的分布情况。方法回顾性分析76例股骨颈骨折后股骨头的SPECT-CT检查资料,股骨颈骨折采用Garden分型,并将股骨头分为外上方(A)、外下方(B)和内下方(C)三个区域,分别计算患/健股骨头核素比值和三个区域与健侧股骨头核素计数比值,比较股骨颈不同类型骨折、同种骨折股骨头不同部位血供的变化。结果 GardenⅠ、Ⅱ、Ⅲ和Ⅳ型患/健比均值分别为:2.6、1.7、0.7和0.4(F=2.34,P<0.05)。股骨头外上方、外下方和内下方与健侧股骨头的核素比分别为:(GardenⅠ型)1.9、3.2、2.4(F=3.85,P<0.05),(GardenⅡ型)1.3、2.3、1.6(F=4.56,P<0.05),(GardenⅢ型)0.3、0.9、0.5(F=3.47,P<0.05),(GardenⅣ型)0.1、0.6、0.3(F=2.73,P<0.05)。结论股骨颈骨折移位程度越大,股骨头血供破坏越严重,尤其是股骨头的外上方部位血供下降程度最为明显。Objective The purpose of this study was to evaluate the blood perfusion within the femoral head after femoral neck fracture by single photon emission computerized tomography and computerized tomography （SPECT/CT）. Methods The femoral head perfusion after fracture of 76 cases with femoral neck fracture were retrospectively evaluated by studying the SPECT/CT data. The Garden classification was used and the femoral head was divided up into three sections： superolateral, lateral inferior and medial inferior regions. The ratios of the radionuclide uptake of the fractured femoral head to that of the contralateral femoral head were calculated and used to assess the femoral head vascularity. Results The radionuclide uptake ratios of the fracture side femoral head to contralateral side in superolateral, lateral inferior and medial inferior regions were as follows： （Garden Ⅰ） 1.9, 3.2, 2.4, （Garden Ⅱ） 1.3, 2.3, 1.6, （Garden Ⅲ） 0.3, 0.9, 0.5, （Garden Ⅳ） 0.1, 0.6, 0.3 （F=2.73, P0.05） Conclusions The greater the displacement in the femoral neck fracture is, the higher degree of ischemia will be. The perfusion in the superolateral region of the femoral head would decline more severely than the lateral inferior and medial inferior regions of the femoral head.

关 键 词：SPECT-CT 股骨颈骨折 股骨头坏死 

分 类 号：R683.42[医药卫生—骨科学]