SARS病人骨缺血性坏死2年后的MRI随访

MRI FOLLOW-UP SURVEY ON ISCHEMIC NECROSIS OF BONE IN SARS PATIENTS AFTER 2 YEARS

目的：探讨并随访SARS康复期病人骨缺血坏死影像学表现及原因。方法：使用1．5T MR扫描仪自2003—08—2005—07对42例SARS康复期病人行髋关节及膝关节检查，分析影像学表现及近期内变化。结果：SARS发病后0．5aMRI显示22例，共44个部位；其中双侧股骨头14例，单侧股骨头8例，3例合并双侧股骨髁，1例合并双侧股骨干；20例未见骨骼病变。骨缺血坏死典型影像学表现为负重关节面下出现线条状异常信号，在T1WI为低信号，T2WI脂肪抑制上呈明显高信号。42例分别在SARS康复后停用激素1a及2a复查MRI，1例双侧股骨干梗死者，2a后复查MRI病变范围明显缩小，其它部位坏死骨未见明显进展恶化及明显吸收好转。未见异常的20例，仍未见骨坏死。结论：激素的使用、病人对激素的敏感性和个体差异是骨坏死的重要原因，SARS所致骨缺血坏死在激素治疗停止后，病变多无变化。

Objective ：To investigate and follow -up the radiologic images of ischemic necrosis and causes. Methods：42 SARS patients in convalescence were examined from August 2003 to July 2005 by using 1.5T MR scanner. Its radiologic images and varieties in shorter stage were analyzed. Restilts ： The ischemic necrosis of bone after 0.5 year was revealed in 22 cases involving 44 positions, including 36 femoral heads,6 femoral condyles, and 2 femoral shafts. 14 of 22 was bilateral necrosis of femoral heads ,8 of 22 was unilateral necrosis of femoral beads, 3 of 22 was bilateral necrosis of femoral condyles, 1 of 22 was bilateral necrosis of femoral shaft. 20 of 42 was not found ischemic necrosis of bone . The main MR manifestation was irregular longer T1 signal in T1WI and irregular longer T2 signal in T2WI FAT. 42 after one and two years were examined, 1 bilateral necrosis of femoral shaft was obviously absorbed. The others was not found obviously change. Normal 20 of 42 was not yet found ischemic necrosis of bone. Conclusion： The use of hormone, the sensitivity to hormone and the difference of individuals are important causes of ischemic necrosis of bone. Ischemic necrosis of bone caused SARS after stop using hormone was not detected obvious changes.