影像学对Legg-Calve-Perthes病预后判断的价值

The value of imaging in evaluating the prognosis of Legg-Calve-Perthes Disease

目的：探讨影像学检查对儿童Legg-Calve-Perthes病（LCPD）预后判断的价值。方法：49例LCPD,其中X线平片49例,CT 15例,MRI 8例,99mTc-MDP骨显像2例,DSA和动脉内药物灌注5例,X线平片采用Catterall分级方法。结果：49例53髋LCPD,初诊I级6髋,Ⅱ级6髋,Ⅲ级13髋,Ⅳ级20髋,修复后扁平髋和巨髋、大转子高位8髋。治疗后32例38髋LCPD得到随访,随访时间4-39（17.7±10.5）月,其中I级5髋变差,1髋痊愈;Ⅱ级2髋变差,2髋好转;Ⅲ级5髋变差,5髋好转;Ⅳ级3髋变差,15髋好转。结论：影像学检查对LCPD预后判断起重要作用,其中X线平片分期对本病的诊治有重要的指导意义,患者避免负重预后好。

Objective：Study the image findings of Legg-Calve-Perthes Disease （LCPD） for evaluating the prognosis. Methods：Forty-nine cases of LCPD were selected,among them 49 cases had plain radiographs, 15 CT scans,8 MRI scans,2 bone scans with ^99mTc-MDP,5 cases received DSA and intra-artery perfusion. The staging methods of radiographs adopted the Catterall＇s classification. Results： Forty-nine cases had 53 LCPD initially diagnosed with radiographs and other imaging methods, among them 6 LCPD were Catterall Ⅰ group, 6 Ⅱ , 13 Ⅲ, 20 Ⅳ, 8 LCPD presented with coxa plana or coxa magna with greater trochanteric prominence after recovery. 38 LCPD of 32 cases had been followed up after treatment with mean time of 4 to 39 （17.7-±10. 5）months. Among them,alteration in the final result rating in Catterall I group5 fair to poor and 1 poor to heal;Catterall Ⅱ group2 fair to poor and 2 poor to fair;Catterall Ⅲ group5 fair to poor and 5 poor to fair;Catterall IV group3 fair to poor and 15 poor to good. Conclusion： Evaluating the prognosis of LCPD depends largely on the image findings,among them the stages based on X-ray plain film demonstrates a significant role. If the patients persists in relieve weight bearing that they could get the better result.