MRI评价早期激素性股骨头坏死患者的微循环变化研究  

MRI Evaluation of Microcirculation Changes in Patients with Early Hormone Induced Femoral Head Necrosis

作　　者：耿加宏 周超 伍晗 GENG Jiahong;ZHOU Chao;WU Han(Department of radiology,Jinhu hospital of traditional Chinese medicine,Jiangsu Province,Huaian,Jiangsu 211600)

机构地区：[1]江苏省金湖县中医院放射科,江苏淮安211600

出　　处：《中国伤残医学》2024年第4期25-28,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨核磁共振成像(MRI)评价早期激素性股骨头坏死(SNFH)患者的微循环变化价值.方法:本研究选取2019年2月-2022年12月本院诊治的76例疑似早期激素性股骨头坏死患者为研究对象,所有患者均给予MRI检查,记录成像特征与微循环变化情况,判断诊断价值.结果:在76例患者中,病理诊断为早期激素性股骨头坏死26例(股骨头坏死组)与髋关节骨性关节炎50例(骨关节炎组).股骨头坏死组的MRI的骨小梁模糊、骨髓水肿、局部囊变、线样征等占比分别为80.8%、84.6%、92.3%、80.8%,均高于骨关节炎组的12.0%、16.0%、50.0%、20.0%,组间差异有统计学意义(P<0.05).股骨头坏死组的核磁共振微循环脂肪分数、灌注分数均高于骨关节炎组,组间差异有统计学意义(P<0.05).MRI判断为早期激素性股骨头坏死25例,MRI鉴别诊断早期激素性股骨头坏死患者的敏感性与特异性分别为96.2%、100.0%,受试者工作特征(ROC)曲线分析显示MRI鉴别诊断早期激素性股骨头坏死患者的最大曲线下面积为0.877.结论:早期激素性股骨头坏死患者在MRI上多表现为骨小梁模糊、骨髓水肿、局部囊变、线样征,伴随有微循环脂肪分数、灌注分数增加,MRI诊断早期激素性股骨头坏死患者具有很高的敏感性与特异性.Objective:To explore the value of magnetic resonance imaging(MRI)in the evaluation of microcirculation changes in patients with early steroid-induced osteonecrosis of the femoral head(SNFH).Methods:In this study,76 patients with suspected early steroid-induced osteonecrosis of the femoral head diagnosed and treated in our hospital from February 2019 to December 2022 were selected as the research objects.All patients were given magnetic resonance imaging examination,and the imaging characteristics and microcirculation changes were recorded to determine the diagnostic value.Results:Among the 76 patients,26 patients were pathologically diagnosed as early steroid-induced osteonecrosis of the femoral head(ONFH group)and 50 patients were pathologically diagnosed as hip osteoarthritis(OA group).The proportions of bone trabeculae blur,bone marrow edema,local cystic degeneration,and linear sign in the femoral head necrosis group were 80.8%,84.6%,92.3%,and 80.8%,respectively,which were higher than 12.0%,16.0%,50.0%,and 20.0%in the osteoarthritis group respectively,and the differences between the groups were statistically significant(P<0.05).The MRI microcirculation fat fraction and perfusion fraction in the osteonecrosis group were higher than those in the osteoarthritis group,and the difference between the groups was statistically significant(P<0.05).Twenty-five cases were diagnosed as early steroid-induced osteonecrosis of the femoral head by magnetic resonance imaging.The sensitivity and specificity of MRI in the differential diagnosis of early steroid-induced osteonecrosis of the femoral head were 96.2%and 100.0%,respectively.Receiver operating characteristic(ROC)curve analysis showed that the maximum area under the curve of MRI in the differential diagnosis of early steroid-induced osteonecrosis of the femoral head was O.877.Conclusion:Patients with early steroid-induced osteonecrosis of the femoral head on MRI mostly show bone trabecula blur,bone marrow edema,local cystic degeneration,linear sign,accompanied by the i

关 键 词：早期激素性股骨头坏死 MRI 骨髓水肿 微循环 脂肪分数 灌注分数 

分 类 号：R683[医药卫生—骨科学]