MRI对股骨头缺血坏死诊断价值的探讨

MRI in the diagnosis of the avascular necrosis of the femoral head

目的 探讨成人股骨头缺血坏死（ANFH）的MRI表现和诊断价值。方法 回顾性分析50例（75个股骨头）ANFH，其中男41例，女9例，平均年龄46岁。病例均行MRI检查，30例行X线检查，21例行CT检查。结果X线、CT及MRI诊断ANFH的阳性率分别为77．1％、80．7％、100％。按Metehell分级：A级8个，B级15个，C级39个，D级13个。12个具有“双线征”。ANFH引起的关节积液为Ⅱ一Ⅲ级的58个（77．3％）。结论 MRI是诊断ANFH的有效手段，对ANFH的诊断特别是早期ANFH的诊断优于CT和X线平片。

Objective To study the MRI findings and diagnostic value of avascular necrosis of the femoral head （ANFH） in adult. Methods Fifty cases（75 hips） with ANFH confirmed by clinic and MRI were included this study. The study group consisted of 41 male and 9 female,aging from 20 -70 years with average of 46 years. In all cases ,various imaging methods were performed including MPd scans（50 cases） ;X -ray film（30cases） ;CT scans （21cases）. Results The positive rate of X -ray film,CT and MRI for diagnosis of FHAN were 77. 1% ,80. 7%, 100%, respectively. According to Metchell＇s grade： A grade （ 8hips ）, B grade grade （ 15hips ）, C grade （39hips）, D grade （13hips）. ＂Double -line sign＂ on MRI appeared in 12 hips and the joint effusion with Ⅱ-Ⅲ grade of ANFH were found in 58 hips（77.3% ）. Conclusion MRI is a choice method for diagnosing ANFH,and is superior to both CT and X -ray plain film for diagnosing ANFH,especially for early ANFH.