非创伤性股骨头坏死MRI骨髓水肿征象与病程分期的相关性探讨  

Correlation between MRI Aigns of Bone Marrow Edema and Stage of Disease Course in Nontraumatic Osteonecrosis of Femoralhead

作　　者：祁同宁 常韬[2] 刘允珍 许宏伟[4] 班明辉 QI Tong-ning;CHANG Tao;LIU Yun-zhen;XU Hong-wei;BAN Ming-hui(Department of Rehabilitation Medicine,Chengde Central Hospital,Chengde 067000,Hebei Province,China;Department of Orthopeadic Surgery,Chengde Central Hospital,Chengde 067000,Hebei Province,China;Medical Examination Center,Chengde Central Hospital,Chengde 067000,Hebei Province,China;Department of Imaging,Chengde Central Hospital,Chengde 067000,Hebei Province,China)

机构地区：[1]承德市中心医院康复医学科,河北承德067000 [2]承德市中心医院骨外科,河北承德067000 [3]承德市中心医院体检中心,河北承德067000 [4]承德市中心医院影像科,河北承德067000

出　　处：《中国CT和MRI杂志》2021年第12期171-173,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨非创伤性股骨头坏死MRI骨髓水肿征象与病程分期的相关性。方法对2018年1月至2019年1月于我院就诊治疗的78例(98髋)股骨头坏死成人患者的临床、病理及影像学资料进行回顾性整理分析,记录不同病情患者骨髓水肿情况,并总结其影像学特征表现。结果98髋Ⅱ期和Ⅲ期患者骨髓水肿发生率较Ⅰ期高,而到Ⅳ期时骨髓水肿发生率逐渐下降,水肿程度也逐渐减轻,未出现3级水肿;但Ⅱ期和Ⅲ期患者2级、3级骨髓水肿发生率显著高于Ⅰ期,且Ⅲ期骨髓3级水肿发生率显著高于Ⅱ期(P<0.05)。98髋MRI显示均存在线条状异常信号即“线样征”,伴有骨髓水肿髋表现为T1WI上偏低信号,T2WI高信号,病灶周围及远侧区表现为范围大小不等、边界不清的长T1、等或稍长T2异常信号,脂肪抑制序列T2WI呈明显高信号。结论MRI显示中骨髓水肿程度与NONFH患者病情分期有着密切联系,水肿的伴随提示病灶的存在,而水肿范围的扩大即提示病情进展越为严重,可根据MRI检查中所表现的骨髓水肿的程度、进展及消退来评估NONFH患者病情进展或治疗效果。Objective to explore the correlation between MRI signs of bone marrow edema and stage of disease course in nontraumatic osteonecrosis of femoralhead.Methods the clinical,pathological and imaging data of 78 patients(98 hips)with nontraumatic osteonecrosis of femoralhead who were treated in our hospital from January 2018 to January 2019 were retrospectively analyzed.the bone marrow edema of patients with different conditions was recorded.And summarize its imaging features.results the incidence of bone marrow edema in stageⅡand stageⅢof 98 hips was higher than that in stageⅠ,and the incidence of bone marrow edema gradually decreased in stage IV,and the degree of edema gradually decreased.Grade 3 edema did not occurred.However,the incidence of grade 2 and grade 3 bone marrow edema in stageⅡandⅢpatients was significantly higher than that in stageⅠ,and the incidence of grade 3 bone marrow edema in stageⅢwas significantly higher than that in stageⅡ(P<0.05).MRI of 98 hips showed line-like abnormal signal called“line-like sign”,accompanied by a condition that the hips with bone marrow edema showed low signal on t1WI and high signal on t2WI,the surrounding and distal areas of the lesion showed long t1,equal or slightly longer t2 abnormal signals with different range and unclear boundaries,and the fat suppression sequence t2WI showed a significant high signal.Conclusion MRI showed that the degree of bone marrow edema was closely related to stage of disease course of NONFH patients.the accompanying edema indicates the presence of lesions,and the expansion of edema indicates more serious progresses of disease.So the progression or treatment effect of NONFH patients can then be assessed based on the extent,progression,and regression of bone marrow edema performed in MRI.

关 键 词：非创伤性股骨头坏死 磁共振 骨髓水肿病程分期 相关性 

分 类 号：R681.8[医药卫生—骨科学] R445.2[医药卫生—外科学]