成人股骨头缺血性坏死患者临床症状、CT与MRI影像学表现特点分析  

Analysis on Clinical Symptoms,Features of CT,and MRI Findings in Adults with Avascular Necrosis of the Femoral Head

作　　者：王毅 WANG Yi(Department of Imaging,Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州骨科医院影像科,河南郑州450052

出　　处：《中国CT和MRI杂志》2021年第9期176-179,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨成人股骨头缺血性坏死(ANFH)患者临床症状、磁共振成像(MRI)与电子计算机断层扫描(CT)影像学表现特点。方法回顾性分析我院2018年9月至2019年3月收治的82例成人股骨头缺血性坏死患者临床资料,所有患者均接受CT与MRI影像学检查,并经手术病理证实,观察患者临床症状,分析其影像学表现。结果ANFH患者主要症状为髋关节或膝关节疼痛,且呈逐渐加重趋势,关节活动可正常或轻微丧失;经手术病理诊断82例患者164个髋中共包括正常44髋,Ⅰ~Ⅱ期61髋,Ⅲ期53髋,Ⅳ期6髋;CT共检测出ANFH共95髋,检出率为79.17%,MRI共检测出ANFH共111髋,检出率为92.50%,MRI检出率高于CT(P<0.05);MRI诊断Ⅰ~Ⅱ期ANFH敏感度、准确度、阳性预测值、阴性预测值分别为83.61%、92.68%、96.23%、90.99%高于CT诊断(52.46%、79.88、88.89%、77.34%,P<0.05);CT扫描影像学显示ANFH患者骨小梁结构模糊,可见高密度硬化,甚至出现塌陷变形;MRI显示病变一侧股骨头信号不均匀,横断面和冠状位T1序列显示股骨头变形,冠状位T1WI序列上表现出较为明显的"线样征"。结论ANFH患者的CT与MRI影像学表现具有一定的特异性,且MRI诊断效能高于CT扫描。Objective To explore clinical symptoms,features of magnetic resonance imaging(MRI),and computed tomography(CT) findings of adult patients with avascular necrosis of the femoral head(ANFH).Methods A retrospective analysis was performed on clinical data of 82 adult patients with ANFH who were admitted to the hospital during the period from September 2018 to March 2019.All patients underwent CT and MRI examination and confirmed by surgical pathology.Clinical symptoms of patients were observed.Furthermore,their imaging findings were analyzed.Results The main sym ptom of ANFH patients was hip or knee pain,showing a gradual aggravation trend.The joint activity could be normal or slightly lost.Among 164 hips in 82 patients confirmed by surgical pathology,there were 44 normal hips,61 hips in stage Ⅰ-Ⅱ,53 hips in stage Ⅲ, and 6 hips in stage Ⅳ.There were 95 hips with ANFH detected by CT, with a detection rate of 79.17%.There were 111 hips with ANFH detected by MRI,with a detection rate of 92.50%.The detection rate was higher by MRI than CT(P<0.05).The sensitivity,accuracy,positive and negative predictive values of MRI for diagnosis of stage Ⅰ-Ⅱ ANFH were 83.61%,92.68%,96.23%,and 90.99%,which were higher than those of CT(52.46%,79.88,88.89%,77.34%)(P<0.05).CT scan imaging showed that the tra becula r bone struct u re of ANFH patients was blurred.There was high-density sclerosis and even collapse deformation.MRI showed that the signal of the femoral head at the lesion side was uneven.T1 sequence of crosssection and coronal showed deformation of the femoral head.The coronal T1 WI sequence showed a more obvious string sign.Conclusion There is particular specificity of both CT and MRI findings for ANFH patients.The diagnostic efficiency of MRI is higher than CT scan.

关 键 词：成人股骨头缺血性坏死 临床症状 影像学特点 

分 类 号：R816.8[医药卫生—放射医学]