摘要
目的 探讨早期成人股骨头缺血坏死 (FHN)的骨显像征像 ,并与MRI和X线平片征像对比 ,从MRI角度阐述骨显像征像的病理基础。方法 分析 4 0例 6 3髋经随访和病理检查证实的早期成人FHN患者的影像学资料。均于 7d内行髋关节骨显像、MRI和X线检查。结果 ①骨显像上表现为正常、局限性稀疏、局限性浓集、不典型“炸面圈征”、典型“炸面圈征”、股骨头上方轻度浓集而基底部或 (和 )颈部带状明显浓集及股骨头或头颈部弥漫性浓集 ,均对应不同的MRI征像。②骨显像、MRI与X线平片对早期成人FHN诊断阳性率分别为 93 7% ,10 0 %和 71 4 % ,两两比较 ,χ2 值分别为 2 32 ,9 31和 18 73,P >0 0 5 ,<0 0 1和 <0 0 1。结论 ①“炸面圈征”及股骨头上方轻度浓集、基底部或 (和 )颈部带状明显浓集均为骨显像诊断早期成人FHN的特异性征像。②骨显像诊断早期成人FHN的阳性率与MRI相当 ,高于X线平片。
Objective To summarize radionuclide bone scan signs in the early femoral head necrosis (FHN) in adults,to compare them with MRI and X-ray findings and to discuss the pathological basis of radionuclide bone scan findings from the view of MRI. Methods Forty cases(63 hips) with early FHN in adult patients proved by follow-up studies or pathology were analyzed. All patients underwent radionuclide bone scan,MRI and X-ray examination within a period of less than 7 d separately. Results ①Radionuclide bone scan manifestations of the early FHN corresponding to different MRI signs included: focally decreased uptake of radioisotope,focally increased uptake,atypical or typical doughnut sign, mildly increased uptake in the superior part of femoral head with band-like region of obviously increased uptake in inferior part of femoral head or femoral neck,and diffused increase of uptake in the whole head. ②In 40 cases (63 hips),there was statistical difference in diagnosis early FHN in adults not only between radionuclide bone scan and X-ray but also between MRI and X-ray in sensitivity (P<0.01),but no statistical difference between radionuclide bone scan and MRI in sensitivity(P>0.05). Conclusions ①The atypical or typical doughnut sign and mildly increased uptake in the superior part of femoral head with band-like region of obviously increased uptake in inferior part of femoral head or neck are specific signs for diagnosing early FHN. ②For sensitivity,radionuclide bone scan and MRI are equally superior to X-ray.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2004年第4期199-202,共4页
Chinese Journal of Nuclear Medicine
