正常人和股骨头缺血坏死（AVN）患者的髋关节腔积液的MR研究

MR Images of Joint Fluid in the Normal and Ischemic Hip

对６７例（１３４关节）正常人和１４例股骨头缺血坏死（ＡＶＮ）病例（２０个病变关节）的髋关节积液情况进行了ＭＲ研究。发现正常人组中７１％关节内有液体，其中６２％为１级液体（少量）；仅９％为２级液体（中量），无３级液体（大量）；小于５０岁年龄段正常人１００％有液体。在ＡＶＮ病例组中，１００％均有液体，２－３级液体达８５％，与正常人组有明显差异（Ｐ＜０．０００１）；按照病程分期，ＡＶＮ早期（Ⅰ－Ⅱ期病例中，１－２级液体占５４％，３级为４６％；而中晚期（Ⅲ－Ⅳ）中，３级液体达１００％（Ｐ＜０．０５）。结果表明：正常人髋关节内有少量液体，不是异常；在ＡＶＮ病例中，关节腔均有液体增多，液体量增多与病变进展相关。ＭＲ是检查髋关节腔液体的最敏感的无创方法。

MR images in 20 hips with documented avascular necrosis (AVN) and 134 hips without evidence of joint disease were studied to determine the amount of fluid in the joint and the relationship of joint effusions to AVN. The amount of joint fluid was graded from 0 to 3.Joint fluid was seen in 71% of presumed normal hips, only 9% had enough fluid to surroud the femoral neck (grade 2),and none had grade 3. In comparison,17 (85%) of 20 hip with avascular necrosis had grade 2 or grade 3 effusions (P<0.001),and some fluid was seen in all (100%);6 (46%)of 13 hips with stage Ⅰ-Ⅱ had grade 3 effusions,all hips (100%) with stage Ⅲ-Ⅳ had grade 3 effusion (P<05).It is concluded that small amounts of fluid were present in normal hips; the amount of fluid is increaed in the majority of patient with AVN, especially in those with adyanced disease. MRI is a highly sensitive method for detecting fluid in the hip joint.