股骨头坏死ARCO 2期CT征象对新发骨质吸收区预测价值分析  

Predictive Value of CT Signs of ARCO Stage 2 on New Bone Resorption Lesion in ONFH

作　　者：史珊[1] 杨学东[1] 罗萍[1] 孙黎[1] 谢利民[2] 于潼[2] 白杨[2] SHI Shan;YANG Xue-dong;LUO Ping;SUN Li;XIE Li-min;YU Tong;BAI Yang(Department of Radiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Orthopaedics,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

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CT和MRI杂志》2023年第5期148-150,156,共4页Chinese Journal of CT and MRI

基　　金：北京联影智能影像技术研究院基金(CRIBJQY202109);中国中医科学院科技创新工程项目(CI2021A03302和CI2021A03320)。

摘　　要：目的 分析股骨头坏死ARCO 2期CT征象对新发骨质吸收区的预测价值。方法 回顾性分析2011年至2017年进行髋关节CT检查国际骨微循环研究协会(Association Research Circulation Osseous,ARCO)2期的股骨头坏死94例患者(F/M=24/70,中位年龄41.0(33.3-54.0)岁)。评估初次CT检查的征象,包括骨质坏死的位置、ARCO分期范围、密度和增生反应区的形态。根据随访3年有无骨质吸收区将病例分为新发骨质吸收组和无骨质吸收组。对比两组CT征象的差异,并分析单一和CT征象组合对新发骨质吸收区的预测价值。结果 骨质坏死位于中外侧柱或内中外侧柱、坏死范围大于30%及增生反应区呈横行在新发骨质吸收组显著多于无骨质吸收组。CT征象组合2(骨质坏死位置、坏死范围及增生反应区呈横行形态)对新发骨质吸收区的预测价值最大,曲线下面积(Area Under Curve,AUC)为0.79,敏感性和特异性分别为89.13%和62.50%,阈值>1。结论 如果骨质坏死区位于中外侧柱或内中外侧柱,坏死范围大于30%,且增生反应区呈横行,则易发生骨质吸收区,应密切随访。Objective To analyze the predictive value of CT signs for new bone resorption lesion in Association Research Circulation Osseous(ARCO)stage 2 ONFH.Methods Ninety four patients underwent hip CT examination with ARCO stage 2 ONFH from 2011 to 2017 were retrospectively analyzed((F/M=24/70,median age 41.0(33.3-54.0)years old)).The signs of the initial CT examinations,including the location of the osteonecrosis,ARCO range of osteonecrosis,density of the osteonecrosis,and morphology of the necrotic-viable interface were evaluated.According to whether there was bone resorption in 3 years of follow-up,the cases were divided into new bone resorption group and no bone resorption group.The differences in CT signs between the two groups were analyzed,and the predictive values of the single and combined CT signs on the presence of new bone resorption lesion were analyzed.Results The osteonecrosis lesion located in the central-lateral column or the medial-central-lateral column,the range of necrosis greater than 30%,and the necrotic-viable interface with morphology of transverse were significantly more in the new bone resorption group than the non-bone resorption group;the combined CT signs 2 had the greatest predictive value for new bone resorption lesion with AUC of 0.79,sensitivity and specificity are 89.13%and 62.50%,respectively,and the threshold is>1.Conclusion If osteonecrosis lesion is located in the central-lateral column or the medial-central-lateral column,the necrosis range is greater than 30%,and the necrotic-viable interface is transverse,the bone resorption lesion is prone to occur and should be followed up closely.

关 键 词：股骨头坏死 骨质吸收 CT ARCO 2期 

分 类 号：R617[医药卫生—外科学]