bBMP/胶原/珊瑚复合人工骨修复股骨头骨缺损的影像学研究  

A Radiographic Study of bBMP/Collagen/Coral Composited Bone Substitute in Repairing of Bone Defect of Femoral Head

作　　者：徐小良[1] 同志勤[2] 王坤正[2] 王社教[2] 杨增华[2] 牒军[2] 宋厂义[2] 党晓谦[2] 阎宏伟[2] 李旭东[2] 陈君长[2] 

机构地区：[1]上海第二医科大学附属第九人民医院骨科,200011 [2]西安交通大学第二医院骨科,710004

出　　处：《现代医用影像学》2001年第1期3-7,共5页Modern Medical Imageology

摘　　要：目的 :研究用复合人工骨治疗股骨头坏死的效果。材料与方法 :建立双侧股骨头内骨缺损模型 ,并分为 4组 :①bBMP/胶原 /珊瑚复合人工骨组 (95侧 )、②肌骨瓣组 (5侧 )、③单纯珊瑚组 (4侧 )、④对照组 (14侧 (为以上各组的对侧)。对造模后及植入后定时行普通X线、核素骨显像、MRI及CT检查。结果 :(1)核素骨显像示 :6周及 12周 ,I组股骨头核素摄取量静态相头 /干比升高 ,但血液相及血池相不升高。 (2 )MRI示 :10周 ,I组原骨缺损区内T1WI及T2 WI均为低信号区 ,提示多量新生骨形成 ,Ⅳ组T1WI及T2 WI示中部为高信号区 ,周围为环形低信号带 ,提示囊腔中为脂肪性骨髓 ,周围为硬化带。 (3)拍片及CT示 :14～ 16周 ,I组骨缺损大多完全闭合 ,珊瑚已吸收 ,其余各组骨缺损部分残留 ,Ⅳ组骨缺损囊壁硬化带形成。结论 :该复合人工骨有较强的传导成骨及诱导成骨作用 ,是修复股骨头骨缺损的良好移植材料 。Purpose:To evaluate the effectiveness of bBMP/collagen/coral composited bone substitute in treatment of avascular necrosis of the femoral head(ANFH).Materials and Methods:Canine bone defect of bilateral femoral head was established,They were devided into 4 groups:I.composited bone substitute group(n=5),Ⅱ.muscle pedicle bone group(n=5),Ⅲ.simple coral group(n=4),Ⅳ.control group:contralateral hip(n=14).Roentgenography,Scintigraphy,MRI,CT were examined and studied at various time.Results:(1)Scintigraphic changes:In group I,static bone image showed increased radionuclide uptake,but blood-flow and blood-pool image didn′t show at 6th and 12th week.(2)MRI changes:In group I,T 1WI and T 2WI showed a low signal intensity in the bone defect at 10th week;In group Ⅳ,T 1WI and T 2WI showed a high signal intensity at the center and a low signal intensity at the wall of bone defect (3)Roentgenographic and CT changes:At 14～16th week,in group I,the coral was absorbed,most of the bone defects were closed completely;In the rest groups,part of each bone defect was remained;I group Ⅳ,cystic sclerosis was formed.Conclusion:The composited bone substitue possesses a superior osteoinductivity and osteoconductivity in the repairing process of bone defect of femoral head,but it can′t improve the revascularization of ANFH.

关 键 词：股骨头坏死 骨缺损 骨形态发生蛋白 珊瑚 人工骨 影像学 

分 类 号：R816.8[医药卫生—放射医学]