磁共振成像对股骨头坏死后塌陷的预测(1)
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[摘要] 目的:探讨一种临床上实用的磁共振成像(MRI)检测手段来预测股骨头坏死(osteonecrosis of the femoral head, ONFH)的塌陷。方法:选择37例ARCO分期为Ⅰ期和Ⅱ期的ONFH患者,在MRI的中部冠状位和矢状位图像上分别测量坏死角度,根据公式计算坏死范围指数,比较塌陷组和未塌陷组该指数的差异,并根据该指数对患者发生股骨头塌陷的危险程度进行分级。平均随访期为25个月。结果:塌陷组和未塌陷组的坏死范围指数分别为56.13±17.65和18.34±10.87,差异有统计学意义。随访中无一例股骨头发生塌陷的低危组,其股骨头坏死范围指数均小于30；股骨头均发生塌陷的高危组,其股骨头坏死范围指数均大于40；而中危组的坏死范围指数介于30～40,股骨头塌陷发生率为45%。结论:利用MRI测量和计算ONFH的坏死范围指数是预测ONFH患者是否发生股骨头塌陷的有效方法。
[关键词] 磁共振成像； 股骨头坏死； 塌陷； 预测
[中图分类号] R681.8 [文献标识码] A [文章编号] 1671-7256(2011)02-0194-03
doi：10.3969/j.issn.1671-7256.2011.02.023
Magnetic resonance imaging predicts collapse of osteonecrosis
of the femoral head
GU Han-shen1, JIN Dong-sheng1, LI Shen-er2
(1. Jiangsu Province Official Hospital, Department of Radiology, Nanjing 210024, China； 2. Jiangsu Province Hospital,Department of Radiology, Nanjing 210029, China)
[Abstract] Objective: To explore a practical magnetic resonance imaging(MRI) method to predict the collapse of osteonecrosis of the femoral head(ONFH). Method: 37 patients with ONFH in ARCO stage I or II were adopted. The mean follow-up period was 25 months. The angles of necrotic area in the mid-coronal and mid-sagittal image were obtained to calculate the index of necrotic extent by the formula. The difference of the index between collapsing and non-collapsing group was compared. According to the index, patients were divided into high-risk, middle-risk and low-risk group in order to predict the collapse risk of ONFH. Results： The index of necrotic extent in the collapsing and non-collapsing group was 56.13±17.65 and 18.34±10.87 respectively with significant difference. No patient collapsed in the low-risk group with index less than 30, however they all collapsed in the high-risk group with index more than 40, 45% patients in the middle-risk group with index between 30 and 40 collapsed. Conclusion： The index of necrotic extent by MRI is the useful method to predict the collapse risk of ONFH.
[Key words] magnetic resonance imaging; osteonecrosis of the femoral head; collapse; prediction ......
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