磁共振STIR序列在早期股骨头缺血性坏死诊断中的应用

Usefulness of MRI with STIR sequence in the early diagnosis of avascular necrosis of femoral head

目的评价磁共振STIR序列对股骨头缺血性坏死(ANFH)早期诊断的临床应用价值。方法对经MRI普查后STIR序列显示不同程度骨髓水肿及关节积液,而常规T1WI及T2WI未明确提示ANFH特征性改变的18例临床高危患者4～6个月后复查,对其影像征象进行分期和对比性分析。结果复查后有14例患者(共25部位股骨头)可诊断为Ⅰ～Ⅱ期ANFH,病变部位与MRI初次检查时STIR序列所显示的骨髓水肿部位基本一致。结论 MRI在检测ANFH病变中具有较高的敏感性,尤其STIR序列对ANFH的早期诊断具有极高的应用价值。

Objective To evaluate the usefulness of magnetic resonance imaging（MRI） with short-T1 inversion recovery（STIR） sequence in the early diagnosis of avascular necrosis of femoral head（ANFH）.Methods Eighteen patients with clinically suspected ANFH underwent conventional MRI and then STIR sequence examinations.STIR sequence initially showed more or less marrow edema and articular hydrops in the group patients but conventional MR T1WI and T2WI sequences did not show any change characteristic of ANFH.In order to perform Ficat staging and comparative analysis of MRI signs,all these patients underwent again the reexaminations using MRI with STIR sequence at 4-6 months after first MRI examinations.Results The reexaminations demonstrated that 14（25 femoral heads） of 18 patients could be diagnosed as stage Ⅰ or stage Ⅱ of ANFH,while the locations of marrow edema were basically corresponding to those on initial STIR images.Conclusion MRI in detecting ANFH has higher sensitivity,especially STIR sequence plays a critical role in the early diagnosis of ANFH.