CT影像的形态学表现在预测双侧股骨头坏死发生塌陷的独立危险因素中的应用  

Application of CT Image Morphology in Predicting Independent Risk Factors of Bilateral Femoral Head Necrosis Collapse

作　　者：曾锦 谭坚毅[1] 旺剑晖 Zeng Jin;Tan Jianyi;Wang Jianhui(People's Hospital of Gaoming District,Foshan City,Foshan Guangdong 528500,China)

机构地区：[1]佛山市高明区人民医院,广东佛山528500

出　　处：《医疗装备》2022年第1期116-118,共3页Medical Equipment

摘　　要：目的探讨CT影像的形态学表现在预测双侧股骨头坏死发生塌陷的独立危险因素中的应用。方法回顾2019年11月至2020年11月医院收治的100例双侧股骨头坏死患者的临床资料,并观察其CT表现,采用单因素分析法及多因素Logistic回归分析法探寻发生双侧股骨头坏死塌陷的危险因素。结果通过观察双侧股骨头坏死患者的CT影像可发现,正常的股骨头和病灶骨交界处有带状硬化区,带状硬化区表现为异常高密度簇状,同时具备斑片状形态,该带状硬化区可发展至软骨下部,塌陷处正常星芒结构可见部分消失甚至中断。100例患者中,61例(61%)发生双侧股骨头坏死塌陷。单因素分析结果显示,发生双侧股骨头坏死塌陷患者股骨头坏死分期为Ⅲ~Ⅳ期、坏死面积>30%、软骨下方非均匀肥厚的占比与未发生双侧股骨头坏死塌陷患者比较,差异均有统计学意义(P<0.05);两类患者的其他因素比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,影响双侧股骨头坏死塌陷发生的独立危险因素为股骨头坏死分期为Ⅲ~Ⅳ期、坏死面积>30%、软骨下方非均匀肥厚(P<0.05)。结论CT影像的形态学分析可以在一定程度上帮助临床医师预测双侧股骨头坏死塌陷的风险,股骨头坏死分期为Ⅲ~Ⅳ期、双侧股骨头坏死面积>30%及软骨下方非均匀肥厚是导致双侧股骨头坏死塌陷的独立危险因素。Objective The application of CT image morphology in predicting the independent risk factors of bilateral femoral head necrosis collapse was explored.Methods The clinical data of 100 patients with bilateral femoral head necrosis admitted to the hospital from November 2019 to November 2020 were reviewed,and their CT findings were observed.Univariate analysis and multivariate Logistic regression analysis were used to explore the risk factors for the occurrence of bilateral femoral heads necrosis collapse.Results By observing the CT images of patients with bilateral femoral head necrosis,it can be found that there is a band-shaped sclerosis zone at the junction of the normal femoral head and the lesion bone.The band-shaped sclerosis showed abnormal high density clusters and patch as well.This band-shaped sclerosis can develop to the lower cartilage,and the normal starburst structure at the collapsed area can be seen partially disappeared or even interrupted.Among 100 patients,bilateral femoral heads necrosis collapse occured in 61 patients,accounting for 61%.The results of univariate analysis showed that the proportions of stageⅢtoⅣfor bilateral femoral head necrosis,the necrosis area was>30%,and the non-uniform hypertrophy under the cartilage of the patients with bilateral femoral head necrosis collapse were all higher than those only with bilateral femoral head necrosis(without collapse),and all the differences were statistically significant(P<0.05);There was no statistically significant difference in other factors between the two types of patients(P>0.05).The results of multivariate Logistic regression analysis showed that the independent risk factors affecting the occurrence of bilateral femoral head necrosis collapse were stageⅢ~Ⅳfor femoral head necrosis,the necrosis area>30%,and the non-uniform hypertrophy under the cartilage(P<0.05).Conclusions The morphological analysis of CT images can help clinicians to predict the risks of bilateral femoral head necrosis collapse to a certain extent.The stageⅢ~�

关 键 词：CT影像 形态学分析 双侧股骨头坏死塌陷 独立危险因素 

分 类 号：R816.8[医药卫生—放射医学]