高原地区成人股骨头缺血性坏死X线及CT影像诊断价值  

Diagnostic value of X-ray and CT images in adults avascular necrosis of femoral head in plateau area

作　　者：高晓莉 次旦旺久[2] Gao Xiaoli;Cidanwangjiu(Medical College of Tibet University,Lhasa 850000,China)

机构地区：[1]西藏大学医学院 [2]西藏自治区人民医院放射科

出　　处：《实用医学影像杂志》2022年第6期567-570,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨X线及CT影像检查在高原地区成人股骨头缺血性坏死不同时期诊断中的应用价值。方法回顾性收集2013年10月至2021年1月于我院经手术病理证实为股骨头缺血坏死临床及影像资料,所有患者均有完整的骨盆X线检查及CT影像资料。由2名多年影像诊断经验放射科医生共同阅片分别对比骨盆X线和CT影像图像进行分期,比较X线及CT检查股骨头分期的准确性。结果据纳入及排除标准最终纳入44例(88髋);X线及CT检查对股骨头缺血坏死的准确率分别为87.5%、96.6%,差异有统计学意义(χ^(2)=4.97,P=0.03)。CT对股骨头缺血坏死Ⅰ期和Ⅱ期准确率明显高于X线,差异有统计学意义(P<0.05),对Ⅲ期CT准确率略高于X线,但差异无统计学意义(P>0.05),Ⅳ期两者准确率均达到100%。结论Ⅰ期和Ⅱ期股骨头缺血坏死CT准确率明显高于X线检查,X线检查结果阴性患者如果临床高度可疑股骨头缺血坏死,应需要进一步CT检查。Objective To investigate the diagnostic value of X-ray and CT imaging in different periods of adult avascular necrosis of femoral head in plateau area. Methods The clinical and imaging data of avascular necrosis of femoral head confirmed by surgery and pathology in our hospital from October 2013 to January 2021 were retrospectively collected. All patients had complete pelvic X-ray examination and CT imaging data. Two radiologists with years of experience in imaging diagnosis read films together to compare X-ray and CT imaging images for staging,and to compare the accuracy of X-ray and CT examination of femoral head staging. Results According to the inclusion and exclusion criteria, 44 cases(88 hips) were finally included. The accuracy rates of X-ray and CT examination for avascular necrosis of femoral head were 87.5 % and 96.6%, respectively, and the difference was statistically significant( χ^(2)=4.97, P=0.03). The accuracy of CT in stage Ⅰ and Ⅱ of femoral head necrosis was significantly higher than that of X-ray, and the difference was statistically significant(P=0.03). The accuracy of stageⅢCT was slightly higher than that of X-ray, but the difference was not statistically significant(P>0.05). The accuracy rate of both in stage Ⅳ reached 100 %. Conclusion The CT accuracy of stage Ⅰ and stage Ⅱ femoral head necrosis was significantly higher than that of X-ray examination. If the patients with negative X-ray examination results are highly suspected of avascular necrosis of the femoral head, further CT examination should be required.

关 键 词：体层摄影术 X线计算机 股骨头坏死 放射摄影术 

分 类 号：R681.8[医药卫生—骨科学] R816.8[医药卫生—外科学]