人工髋关节置换术后并发症影像学表现  

Imaging features of complications after hip arthroplasty

作　　者：汪飞[1] 邱麟[1] 佘国荣[2] 沈思[1] 刘斯润[1] 

机构地区：[1]暨南大学附属第一医院影像中心,广东广州510630 [2]暨南大学附属第一医院骨科,广东广州510630

出　　处：《中国医学影像技术》2015年第7期1095-1099,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨人工髋关节置换术后并发症的影像学表现。方法回顾性分析28例（共31例次）人工髋关节置换术后出现并发症而接受髋关节翻修术患者,观察其影像学表现。结果 31例次中,术后诊断股骨头脱位4例次,X线平片表现为股骨头位于髋臼外;无菌性松动22例次,X线表现为假体周围2~30mm的透亮带,其中,假体周围慢性肉芽肿性炎CT/MRI表现为骨质破坏并软组织肿块;感染4例次,X线表现为假体周围2~4mm的轮廓与假体形态不一致的透亮带,MRI表现为感染区软组织肿胀,见环形强化病灶;异位骨化1例次,X线表现为髋臼假体周围软组织大量骨化影。结论假体周围透亮带是人工髋关节置换术后关节松动最重要的X线表现,CT/MRI有助于区分无菌性松动中的假体慢性肉芽肿性炎、以鉴别感染性和无菌性松动。Objective To explore the imaging manifestations of the complications after hip arthroplasty.Methods Totally 28people（31cases）with complications after hip arthroplasty were analyzed retrospectively.The imaging manifestations were observed.Results In 31 cases,4cases had dislocation of femoral head,presenting on radiographs as the femoral head lying out of acetabulum,22 cases had aseptic loosening,presenting on radiographs as the lucent zone（2—30 mm）.Besides,chronic granulomatous inflammation around the prosthesis showed bone destruction and soft tissue mass on CT/MRI images,4cases had infection,presenting on radiographs as the lucent zone（2—4mm）alone the component,and had the different contour of the component.The infected area can be seen as soft tissue swelling and ring enhancement lesions on MRI images,1case had heterotopic ossification,presenting on radiographs as a large number of ossification in the soft tissues around the acetabular prosthesis.Conclusion After hip arthroplasty,the lucent zone around the prosthesis on radiographs had the important diagnostic value of loosening,CT/MRI was helpful to distinguish the aseptic loosening of chronic granulomatous inflammation and identify infection and aseptic loosening.

关 键 词：髋关节置换术 并发症 松动 X线 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R323.45[医药卫生—诊断学]