多层螺旋CT灌注评估股骨颈骨折后股骨头血流动力学  

Evaluation of hemodynamics of femoral head after femoral neck fracture by multi-slice spiral CT perfusion

作　　者：张明贵[1] 李蔚君[1] 吴寒松[2] 李海涛[1] 陈琼[2] 陈卓 傅俊伟[2] 厉位明[1] ZHANG Minggui;LI Weijun;WU Hansong;LI Haitao;CHEN Qiong;CHEN Zhuo;FU Junwei;LI Weiming(Department of Radiology,Jinhua Hospital of Traditional Chinese Medicical,Zhejiang Chinese Medical University,Jinhua,Zhejiang Province 321017,China;Department of Ortho paedics,Jinhua Hospital of Traditional Chinese Medicical,Zhejiang Chinese Medical University,Jinhua,Zhejiang Province 321017,China)

机构地区：[1]浙江中医药大学附属金华市中医医院放射科,浙江金华321017 [2]浙江中医药大学附属金华市中医医院骨科,浙江金华321017

出　　处：《实用放射学杂志》2020年第5期780-783,共4页Journal of Practical Radiology

基　　金：金华市科学技术研究计划项目(2018-4-059).

摘　　要：目的探讨MSCT评估股骨颈骨折患者股骨头血流动力学改变的成像方法和临床应用价值.方法选取单侧股骨颈骨折患者31例,其中GardenⅠ型1例,GardenⅡ型和GardenⅣ型各9例,GardenⅢ型12例.所有患者行股骨头CTP,不同Garden分型之间分别比较各灌注指标,包括血流量(BF)、血容量(BV)、强化峰值(PEI)、对比剂峰值时间(TTP).结果GardenⅡ型与GardenⅢ型BF存在显著差异(P<0.05);GardenⅡ型与GardenⅣ型BF、BV及PEI均存在统计学差异(P<0.05);GardenⅢ型与GardenⅣ型比较,BF、BV、PEI及TTP均无明显统计学差异(P>0.05).GardenⅣ型病例患侧与健侧比较,BF和TTP存在显著统计学差异(P<0.05);GardenⅡ型和GardenⅢ型病例患侧与健侧比较,各灌注指标均无统计学显著差异(P>0.05).结论利用MSCT灌注成像评估不同Garden分型股骨颈骨折后的股骨头血流灌注微循环,对临床治疗方式的选择和判断预后具有显著意义.Objective To evaluate the imaging method and clinical value of MSCT for evaluating hemodynamic changes of femoral head in patients with femoral neck fracture.Methods Unilateral 31 patients with femoral neck fracture,including Garden type Ⅰ case,Garden type Ⅱ 9 cases,Garden type Ⅲ 12 cases and Garden type Ⅳ 9 cases were ollected.All patients rceived CTP of the femoral head。and various perfusion indicators were compared among different Garden types,including blood flow(BF),blood volume(BV),peak enhancetment intensity(PEI)and time to peak(TTP).Results For Garden type Ⅱ and Garden type Ⅲ,BF had significant differences(P<0.05);For Garden type Ⅱ and Garden type Ⅳ,BF,BV and PEI had statistical differences(P<0.05);For Garden type Ⅱ and Garden type Ⅳ,BF,BV,PEI and TTP had no significant statistical difference(P>0.05).For Garden Ⅳ cases,the afected side and the healthy side.BF and TTP had stistically significant differences(P<0.05);For Garden type Ⅱ and Garden Ⅲ cases,the affected side and the healthy side,the perfusion indexes had no statistical significant difference(P>0.05).Condusion MSCT perfusion imaging can be used to evaluate the microcirculation of femoral head blood perfusion for different Garden type femoral neck fractures,which is significant for the selection of clinical treatment methods and prognosis.

关 键 词：股骨颈骨折 缺血坏死 计算机体层成像 灌注成像 

分 类 号：R683.42[医药卫生—骨科学] R814.42[医药卫生—外科学]