磁共振半定量评分对股骨头坏死ARCO分期的Ⅱ~Ⅳ期软骨损伤可靠性研究  

Study on the reliability of MR semi-quantitative scoring on cartilage damage at Ⅱ-Ⅳ stage of ARCO staging of the osteonecrosis of femoral head

作　　者：史珊[1] 杨学东[1] 石凤祥[1] 谢利民[2] 于潼[2] 白杨[2] 孙黎[1] 洪洋[1] SHI Shan;YANG Xue-dong;SHI Feng-xiang(Department of Radiology,Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China;不详)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053 [2]中国中医科学院广安门医院骨科,北京100053

出　　处：《中国医学装备》2023年第1期26-31,共6页China Medical Equipment

基　　金：北京市联影智能影像技术研究院基金(CRIBJQY202109)“利用计算机深度学习技术提高X线平片诊断早期股骨头缺血坏死准确性的研究”;中国中医科学院科技创新工程项目(CI2021A03302)“基于CT影像组学及深度学习法对健脾补肾方治疗ARCO2、3期股骨头缺血坏死疗效的早期预测及评估的研究”(CI2021A03320)“基于CT定量测量及有限元模型分析中医体质对股骨头坏死塌陷影响的力学机制研究”。

摘　　要：目的:评估国际骨循环研究会(ARCO)股骨头坏死(ONFH)分期为Ⅱ~Ⅳ期的ONFH软骨损伤磁共振(MR)半定量评分的可靠性。方法:选取医院诊断为ONFH并行髋关节MR及CT检查的31例患者,其中21例为双侧髋关节病变,病变髋关节共52个。所有患者病例均行Harris髋关节功能评分。用MR半定量评分对所有病例的髋关节软骨损伤状况进行评估,使用组内相关系数(ICC)评估软骨损伤半定量评分的评估者内及评估者间的一致性。比较不同ARCO分期的软骨损伤程度,分析软骨损伤与ONFH的ARCO分期及Harris髋关节功能评分的相关性。结果:软骨损伤半定量评分的评估者内和观察者间均有良好的一致性(ICC=0.916,ICC=0.835;P<0.001)。不同ARCO分期的软骨损伤差异有统计学意义(H=34.586,P<0.01)。软骨损伤评分与ARCO分期和Harris髋关节功能评分具有相关性(r=0.77,r=-0.53,P<0.01)。结论:MR软骨损伤半定量评分对ONFH的ARCO分期Ⅱ~Ⅳ期ONFH软骨损伤评估的一致性强,可靠性高。软骨损伤与ARCO分期及Harris髋关节功能评分有关,软骨损伤的评估有助于协助及优化临床诊疗。Objective: To assess the reliability of magnetic resonance(MR) semi-quantitative scoring on cartilage damage of the osteonecrosis of femoral head(ONFH) at the II-IV stage of ONFH staging of Association Research Circulation Osseous(ARCO). Methods: Thirty-one patients who were diagnosed as ONFH and underwent MR examination and computed tomography(CT) examination in hospital were selected, and 21 cases of them were bilateral hip joint lesion, and there were total of 52 hip joints occurred lesion. All of patients underwent Harris hip joint functional score. MR semi-quantitative scoring was adopted to assess the status of cartilage damage of hip joint of all cases, and the interclass correlation coefficient(ICC) was adopted to assess the consistencies within assessors and among assessors in assessing the semi-quantitative score of cartilage damage. In addition, the degree of cartilage damage among different ARCO staging was compared, and the correlations between cartilage damage and the ARCO staging of ONFH, and between that and Harris hip joint functional scoring were further analyzed. Results: There were favorable consistencies within assessors and among assessors for the semi-quantitative scoring of cartilage damage(ICC=0.916, ICC=0.835, P<0.001), respectively. There was significant difference in cartilage damage among different ARCO stages(H=34.586, P<0.01). The cartilage damage score was respectively related to the ARCO staging and Harris hip joint functional score(r=0.77, r=-0.53, P<0.01). Conclusion: The MR semi-quantitative score of cartilage damage shows strong consistency in assessing ONFH cartilage damage at Ⅱ-Ⅳ stage of ARCO staging, which has high reliability. The cartilage damage is related to ARCO staging and Harris hip joint functional score, respectively. The assessment of cartilage damage contributes to assist and optimize the clinical diagnosis and treatment.

关 键 词：软骨损伤 磁共振(MR) 半定量评分 可靠性 股骨头坏死(ONFH) 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814[医药卫生—诊断学]