CT影像学ONFH患者不同测量层面股骨头HU的观察研究  

Observational Study of Femoral HU at Different Measurement Levels in Patients with ONFH on CT Imaging

作　　者：张桂鑫 张婕 陈志健 郑春红 杨锋 彭磊 赵宇 龚春柱 张乐 ZHANG Gui-xin;ZHANG Jie;CHEN Zhi-jian;ZHENG Chun-hong;YANG Feng;PENG Lei;ZHAO Yu;GONG Chun-zhu;ZHANG Le(Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan Traditional Chinese Medicine Hospital),Shenzhen 518000,Guangdong Province,China;Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Shantou Chaonan Minsheng Hospital,Shantou 515100,Guangdong Province,China;Hunan University of Chinese Medicine,Changsha 410000,Hunan Province,China)

机构地区：[1]深圳平乐骨伤科医院(深圳市坪山区中医院),广东深圳518000 [2]广州中医药大学,广东广州510405 [3]广州中医药大学第三附属医院,广东广州510405 [4]汕头潮南民生医院,广东汕头515100 [5]湖南中医药大学,湖南长沙410000

出　　处：《中国CT和MRI杂志》2024年第12期178-181,共4页Chinese Journal of CT and MRI

基　　金：广东省中医药管理局项目(202205121615112770);深圳市‘医疗卫生三名工程’项目资助(SZZYSM202311020);深圳市坪山区卫生健康系统科研项目(2023223)。

摘　　要：目的分析CT影像学四种不同测量层面股骨头HU的差异及与骨密度相关性,初步探究HU评估ONFH股骨近端骨质的适宜层面。方法回顾性分析2020-2022年115例(188髋)就诊于广州中医药大学第三附属医院股骨头坏死诊疗中心ONFH患者的CT图像,利用ONIS 2.5 PACS阅览软件分别测量四种观测层面下股骨头的HU,比较不同测量层面股骨头HU间差异并评估与骨密度相关性。结果1.常规CT股骨头不同测量层面的HU间具有统计学差异(P<0.05),ARCOⅡ期不同测量层面的股骨头HU无统计学差异(P>0.05);ARCOⅢ期不同测量层面股骨头HU存在统计学差异(P<0.05)。2.股骨头各测量层面HU与骨密度均显著正相关,其中以正中层面相关性最佳(rs=0.536),ARCOⅡ期股骨头全层面HU与BMD的相关性最为紧密(rs=0.614),ARCOⅢ期股骨头正中层面HU与BMD相关性最为紧密(rs=0.500)。结论常规CT测量层面选择对股骨头HU评估ONFH头内的骨质情况存在影响,正中层面可能是初步评估股骨头内稳定与骨质情况的最优选择。针对不同阶段头内骨质情况简易评估选择,ARCOⅡ期宜选取正中层面,前正中层面更适用于ARCOⅢ期患者。Objective Preliminary investigation of the appropriate level of HU for assessing proximal femoral bone quality in ONFH by analysing the differences in femoral HU and correlation with bone density at four different measurement levels on CT imaging.MethodsWe retrospectively analysed the CT images of 115 patients(188 hips)who attended the ONFH Centre of Necrosis of the Femoral Head of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from 2020 to 2022,measured the HU of the femoral head at four observation levels in ONIS 2.5 PACS software,compared their differences and evaluated the correlation with bone mineral density.Results1.There was a statistical difference between the HUs at different measurement planes of the femoral head in conventional CT(P<0.05),and no statistical difference between the HUs at different measurement planes of the femoral head in ARCO II(P>0.05);there was a statistical difference between the HUs at different measurement planes of the femoral head in ARCO Stage III(P<0.05).2.HU and bMD were significantly and positively correlated at all measured levels of the femoral head,with the best correlation at the mid-head plane(rs=0.536),the strongest correlation between HU and bMD at the full-head plane in ARCO II(rs=0.614),and the strongest correlation between HU and bMD at the mid-head plane in ARCO II(rs=0.500).ConclusionT The selection of a conventional CT measurement plane affects the assessment of femoral HU for bone quality in the ONFH head.The median plane may be the optimal choice for initial assessments of stability and bone quality in the femoral head.For straightforward assessments of bone quality in the head at different stages,the median plane is suitable for ARCO II,while the anterior median plane is more appropriate for ARCO III patients.

关 键 词：股骨头坏死 双能X线吸收法 亨斯菲尔德单位 骨密度 骨质疏松 

分 类 号：R681[医药卫生—骨科学]