股骨头坏死介入术后骨髓水肿的变化及其临床意义  

Clinical significance of bone marrow edema after interventional therapy of femoral head necrosis

作　　者：吴庆德[1] 翁志蓬[1] 邹伟民[1] 胡春洪[2] 

机构地区：[1]广州中医药大学附属顺德中医院放射科,广东528333 [2]苏州大学附属第一医院放射科,江苏215006

出　　处：《影像诊断与介入放射学》2013年第1期43-46,共4页Diagnostic Imaging & Interventional Radiology

基　　金：佛山市医学类科技攻关项目(201008206)

摘　　要：目的探讨股骨头坏死介入术后骨髓水肿（BME）的变化及其临床意义。方法2010年10月～2012年1月收治的39例60髋股骨头坏死患者纳入本研究。患者BME根据MRI表现分为0—2级。分别分析术前1级、2级BME患者介入术后1个月、4个月、7个月的BME构成率，并将BME分级与时间分期进行列联表资料的X^2检验、线性趋势检验以及多个独立样本比较的秩和检验。结果60髋中53髋出现BME，其中1级BME有24髋，2级BME有29髋。术前1级BME的不同时间BME构成率差异有统计学意义（P〈0．001）。术后4个月、7个月与术前的BME分级构成率差异均有统计学意义（P〈0．001）。术后1个月与术前、术后4个月与术后7个月的BME分级构成率差异无统计学意义（P〉0．05）。BME分级与时间分期之间无线性变化关系（P〉0．05）。BME介入术后的平均秩次有变小趋势，术前、术后1个月、4个月、7个月分别为65、65、33、31。术前2级BME的不同时间BME构成率差异无统计学意义（P〉0．05）。结论股骨头坏死患者术前1级BME经过介入治疗可以得到明显改善，BME的MRI评价选择在术后4个月较为合适。Objective To assess the clinical significance of bone marrow edema （BME）after interventional therapy of avascular necrosis of femoral head. Methods From October 2010 to January 2012, 39 patients with avaseular necrosis of 60 femoral heads underwent interventional treatment. MRI was performed preoperatively and at 1, 4 and 7 months after interventional therapy. BME was graded from 0 to 2 on MRI. Contingency table analysis, linear regression analysis and rank sum test were used to compare the BME before and after interventional therapy. Results Preoperative BME was noted in 53 of 60 hips with 24 grade 1 and 29 grade 2. For those with grade 1 BME preoperatively, there was significant difference （P 〈 0.001） between the preoperative and 4 month post- treatment as well as between the preoperative and 7 month post-treatment BME grading. There was no linear correlation between the grade of BME and different time periods （P 〉 0.05）. The rank of BME grading decreased from 65 preoperatively and at 1 month to 33 at 4 months and 31 at 7 months after treatment. Conclusions Grade 1 BME in avascular necrosis of femoral head can resolve with interventional therapy. Follow-up MRI should be performed at 4 months after treatment.

关 键 词：股骨头 缺血坏死 骨髓水肿 磁共振成像 介入治疗 

分 类 号：R681.8[医药卫生—骨科学]