激素所致罕见部位骨坏死影像学分析  

The radiological analysis of osteonecrosis in rare positions

作　　者：张雪梅[1] 马玉山 

机构地区：[1]北京市潞河医院放射科,101149

出　　处：《中华放射学杂志》2004年第3期240-243,共4页Chinese Journal of Radiology

摘　　要：目的　探讨SARS恢复期患者罕见部位骨坏死影像学表现及原因。方法　采用平片、0 5TMR机 ,对 2 0 0 3年 6～ 8月间复查的 4 1例SARS恢复期患者四肢骨骼进行检查 ,分析影像学检查结果及其与应用激素的相关性 ;检查距最初使用激素的平均时间为 88 2d(6 7～ 10 6d) ;平均激素(甲基泼尼松龙 )最大用量 392 (32 0～ 4 80 )mg ;平均持续用药时间为 4 7 2 (30～ 70 )d。结果　MRI显示 5例罕见部位骨坏死病变共累及 11个部位。 3例双侧肱骨头坏死 ,其中 1例合并右侧坐骨坏死 ;1例右侧腕舟骨坏死 ;1例双侧跟骨坏死合并右侧距骨坏死。主要MRI表现为各部位的不规则异常信号病灶。平片仅显示 1例右侧坐骨坏死。结论　SARS恢复期患者骨坏死早期发现需做MR扫描 ,而且是多部位扫描 ,激素用量、时间及患者对激素的敏感性和个体差异是骨坏死的重要原因。Objective To analyze the radiological images of osteonecrosis in rare positions in recovered SARS patients, and to study the correlation with the hormone application.Methods The extremities of 41 SARS patients in the recovery stage from June to August in 2003 were examined by using X-ray and 0.5T MR scanner, then the correlation of MR examination results and the application of hormone was analyzed.The mean time interval between the imaging examination and initial hormone application was 88.2 days (66～106 days), the mean maximum hormone (metastab) dose was 392 mg (320-480 mg), and the average medication time was 47.2 days (30-70 days).Results The osteonecrosis of rare positions was revealed in 5 cases involving 11 positions, including bilateral heads of humerus (3), right scaphoid bone (1), right talus (1), bilateral calcaneus (1), and right ischium (1).The main MR manifestation was irregular abnormal signal.Osteonecrosis of right ischium was demonstrated on plain film in only one case.Conclusion MR examination, especially the multi-location scan is necessary in finding the osteonecrosis in SARS patients in the earlier phase.The hormone dose, the medication duration, the sensitivity to hormone, and the difference of individuals are important causes of osteonecrosis.

关 键 词：激素 骨坏死 影像学分析 SARS恢复期 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]