股骨头缺血坏死MRI分期与坏死指数的相关性  

Correlation between MRI stage and necrosis index in avascular necrosis of femoral head

作　　者：陈志清[1] 刘智[1] 田永刚[1] 王树森[1] 肖联平[1] CHEN Zhi-qing;LIU Zhi;TIAN Yong-gang;WANG Shu-sen;XIAO Lian-ping(The Third Central Hospital of Tianjin,Tianjin Key Laboratory of Extracorporeal Life Sup-port for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China.)

机构地区：[1]天津市第三中心医院,天津市重症疾病体外生命支持重点实验室,天津市人工细胞工程技术研究中心,天津市肝胆研究所,天津300170

出　　处：《中国矫形外科杂志》2021年第3期220-223,共4页Orthopedic Journal of China

摘　　要：[目的]探究股骨头缺血坏死(avascular necrosis of femoral head,ANFH)MRI分期与坏死指数的相关性。[方法]2017年1月~2019年12月,82例(100髋)股骨头坏死患者纳入本研究,所有患者均采用1.5T MRI机器进行扫描,采用国际Hungerford分期方法进行MRI图像分期;再采用Koo所提出的方法计算坏死指数。行股骨头坏死分期与坏死指数的秩相关分析,并预测股骨头缺血坏死后发生股骨头塌陷的临界值。[结果]100例ANFH髋部,Ⅰ期38例、Ⅱ期31例、Ⅲ期19例、Ⅳ期12例。随股骨头坏死分期上调,坏死指数显著增加,任意两个分期的坏死指数之间比较,差异具有统计学意义(P<0.05)。Spear⁃man秩相关分析表明:股骨头坏死分期与坏死指数呈显著正相关(P<0.05)。Ⅱ期仅有4例股骨头坏死指数>53.00%,但在Ⅲ期及Ⅳ期中所有股骨头坏死指数均>53.00%。[结论]坏死指数与ANFH分期呈正相关关系,坏死指数为53.00%时可作为股骨头是否发生塌陷的预测临界值。[Objective] To investigate the correlation between MRI stage and necrosis index in avascular necrosis of femoral head(ANFH). [Methods] From January 2018 to December 2019, a total of 82 patients(100 hips) who suffered from ANFH were enrolled in this study. After all the patients underwent 1.5 T MRI examination, the MRI stage of ANFH was determined according to Hungerford criteria,and necrosis index was calculated by using Koo.s method. Spearman correlation analysis was conducted between the MRI stages and necrosis index, whereas threshold of necrosis index for predicting collapse of the femoral head was searched. [Results] Of the 100 ANFH hips, 38 were in stage I, 31 in stage II, 19 in stage III, and 12 in stage IV. As the MRI stage upgrading, the necrosis index significantly increased(P<0.05), with statistical significances between any two stages among them(P<0.05). As result of Spearman rank correlation analysis, the MRI grade proved significantly positively related to the necrosis index(P<0.05). In term of the threshold, only 4 hips in stage II had necrosis index more than 53.00%, whereas all hips in stage III and stage IV had necrosis index more than 53.00%. [Conclusion] The MRI grade is positively correlated to the necrosis index of ANFH in this study, and 53.00% necrosis index might be the predictive threshold for femoral head collapse.

关 键 词：股骨头缺血坏死 MRI 分期 坏死指数 临界值 

分 类 号：R681.8[医药卫生—骨科学]