DR、CT、MRI在股骨头缺血性坏死的诊断和分期中的价值

Diagnostic and Staging Value of DR, CT, MRI in Avascular Necrosis of Femoral Head (ANFH)

目的研究股骨头缺血性坏死(ANFH)的影像学表现、分期,并评价其在诊断和分期中的价值. 资料与方法 30例共43髋ANFH行DR、CT、MRI检查,根据影像学表现进行分期. 结果 DR诊断Ⅰ～Ⅱ期ANFH 13髋,Ⅲ～Ⅳ期19髋,阳性率74.4%;CT诊断Ⅰ～Ⅱ期ANFH 16髋,Ⅲ～Ⅳ期20髋,阳性率83.7%;MRI诊断Ⅰ～Ⅱ期ANFH 22髋,Ⅲ～Ⅳ期20髋,阳性率97.7%.DR、CT、MRI 三者的敏感性比较,经统计学处理,χ2=9.15,P<0.01,三者之间有显著差异. 结论 DR难以发现早期ANFH,CT可提供较多的诊断信息,MRI是早期诊断ANFH最准确、最敏感的检查方法.DR、CT、MRI在分期中都起着重要作用.

Objective To study imaging features of avascular necrosis of the femoral head and to evaluate the value of DR, CT, and MRI in diagnosis and staging of ANFH.Materials and Methods 30 cases with 43 femoral head were examed by DR, CT, and MRI and staging of ANFH was performed based on the imaging findings.Results 13, 16, 22 hips of ANFH in stages Ⅰ-Ⅱ and 19, 20, 20 hips of ANFH in stages Ⅲ-Ⅳ were detected by DR, CT, MRI respectively. The diagnostic accuracy was 74.4% for DR , 83.7% for CT, 97.7% for MRI. Sensitivity contrast is striking (P<0.01) in DR、CT,and MRI.Conclusion It is difficult for DR to detect early stage ANFH. CT scanning could provide more diagnostic information that allows early diagnosis of ANFH. MRI is the most reliable and most sensitive method for the early diagnosis of ANFH. DR, CT, MRI findings play important roles respectively in the staging of ANFH.