股骨头坏死的系列MRI表现

Serial Magnetic Resonance Imaging of ANFH

目的观察系列MRI上股骨头坏死的坏死信号和坏死面积比例变化。方法自1997年至2005年5月,根据股骨头坏死的诊断标准,对10例(20髋)具有两次及以上MRI成像的股骨头坏死进行研究,两次MRI成像平均相差18.1个月,观察其坏死信号和坏死面积比例变化。结果两次MRI检查时,均有180个层面,共有38个层面出现信号改变。在无外科干预及软骨下骨折出现的11髋102个层面中,5个层面发生信号改变;在行髓芯减压治疗的6髋和出现软骨下骨折的3髋78个层面中,33个层面发生信号改变,P=0.000,具有显著统计学差异。第一次MRI检查时的平均坏死面积比例为(52.62±17.90)%;第二次MRI检查时的平均坏死面积比例为(52.24±19.39)%,P=0.687,两者无显著性差异。结论股骨头坏死的坏死面积比例不随病程的延长及临床分期的进展而改变。如无外科干预或软骨下骨折出现,股骨头坏死的信号强度也无明显变化。

Objective To analyze whether the images of ANFH such as signal intensity and the percentage of necrotic surface would change as clinical developed. Methods From 1997 to May 2005, according to diagnosis standard of ANFH, 10 cases （20 hips） with serials MR imaging were reviewed with an average interval time 18. 1 months. Results There were 38 images with signal intensity changed among 180 images in each MRI. There were 5 images with signal intensity changed among 102 images withgut surgical treatment or new collapse. In 6 hips treated by core decompression and 3 hips with collapse developed, there were 33 images changed among 78 images. The percentage of necrotic surface was 52.62%±17.90% on first MRI observation, and 52.2%±19.39% on second MRI observation, and there were no significant differences between them. Conclusion The necrotic surface of femoral head did not vary with the disease development. Without collapse developed or surgery, there were no signal intensity changed.