股骨头塌陷后坐骨股骨间隙的MRI研究  

MRI Study of Ischiofemoral Space after Femoral Head Collapse

作　　者：邢千超 王胜林[1] 仇恒志[1] 白雪冬[1] 万立野[1] XING Qianchao;WANG Shenglin;QIU Hengzhi(Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院放射科

出　　处：《河北医学》2019年第7期1174-1177,共4页Hebei Medicine

基　　金：2016年承德市科学技术研究与发展计划项目,(编号:201606A038)

摘　　要：目的:探讨股骨头塌陷后坐骨股骨间隙(IFS)的变化及其与股方肌间隙(QFS)、股骨偏心距(FO)、股骨颈干角(CCD)的关系。方法:回顾性分析55例经临床确诊的单侧股骨头坏死患者(Ⅲ期31人,Ⅳ期24人)的髋关节MRI图像。分别在T1WI横断面上测量双侧IFS、QFS,在T1WI冠状面上测量双侧FO、CCD,并在PDWI-FS横断面上观察患侧股方肌形态及信号改变。结果:患侧IFS(1.76±0.14cm)、QFS(0.94±0.23cm)、FO(2.78±0.27cm)明显小于健侧(2.19±0.19cm)、(1.71±0.21cm)、(3.83±0.22cm),患侧CCD(134.74±5.48度)大于健侧(130.83±5.14度),两组之间差异均有统计学意义(P<0.05);患侧髋关节IFS与QFS、FO分别呈正相关关系,r=0.757、0.839,P<0.05;而与CCD呈负相关,r=-0.680,P<0.05。Ⅲ期患者患侧IFS(1.81±0.20cm)、QFS(0.99±0.26cm)、FO(2.84±0.27cm)大于IV期患者(1.71±0.14cm)、(0.87±0.15cm)、(2.69±0.26cm),而CCD(133.17±5.10度)小于IV期患者(136.77±5.38度),两组之间均有统计学差异(P<0.05)。结论:股骨头塌陷后相应IFS、QFS及FO减小,而CCD增大;股骨头塌陷导致的坐骨股骨撞击可能参与了股骨头坏死患者髋部疼痛的发生过程。Objective:To explore the changes of ischiofemoral space(IFS)and the relationship between ischiofemoral space with the quadratus femoris space(QFS),femoral offset(FO)and cervicodiaphyseal angle(CCD)after the collapse of the femoral head.Methods:The hip MRI images of 55 patients with unilateral femoral head necrosis(stageⅢ31 cases,stageⅣ24 cases)were retrospectively analyzed.The bilateral IFS and QFS were measured on the cross section of T1WI,the bilateral FO and CCD were measured on the coronal section of T1WI,and observed the morphological and signal changes of the quadratus femoris muscle on the cross section of PDWI-FS.Results The IFS(1.76±0.14cm),QFS(0.94±0.23cm),FO(2.78±0.27cm)in affected side were significantly lower than that in healthy side(2.19±0.19cm),(1.71±0.21cm),(3.83±0.22cm),the CCD(134.74±5.48°)in affected side significantly higher than that in healthy side(130.83±5.14°),the differences between the two groups were statistically significant(P<0.05).The QFS,FO have positive correlation with IFS in the affected side(r=0.757,0.839,P<0.05),while CCD have significant negative correlation with IFS in the affected side(r=-0.680,P<0.05).The IFS(1.81±0.20cm)、QFS(0.99±0.26cm)and FO(2.84±0.27cm)in affected side of stage III patients were significantly higher than those of stage IV patients[IFS(1.71±0.14 cm),QFS(0.87±0.15 cm)and FO(2.69±0.26 cm)],while the CCD(133.17±5.10°)was lower than that of stage IV patients(136.77±5.38°),and there were significant differences between the two groups(P<0.05).Conclusion:The IFS,QFS and FO decrease,while CCD increase after the collapse of the femoral head.The ischial femur impingement caused by the collapse of the femoral head may be involved in the occurrence of hip pain in patients with femoral head necrosis.

关 键 词：坐骨股骨间隙 股骨头坏死 磁共振成像 股骨偏心距 髋部疼痛 

分 类 号：R681.8[医药卫生—骨科学]