成人早期股骨头缺血坏死CT及MRI诊断价值

Diagnosis value of CT and MRI in early avascular necrosis of adult femoral head

①目的探讨CT、MRI对成人早期股骨头缺血性坏死(ANFH)的诊断价值。②方法回顾分析随访确诊51例(69髋)成人早期ANFH的CT和MRI影像学资料,分析其对成人早期ANFH的显示及诊断能力。③结果 51例患者(69髋)均存在早期骨坏死表现。CT发现早期ANFH 42髋,诊断准确率为60.8%,其中Ⅰ期6髋,Ⅱ期36髋。主要表现为股骨头外形正常,星芒状骨小梁结构增粗、变形、模糊,股骨头可有点、片状密度增高影或条状致密影。MRI发现早期ANFH 69例,诊断准确率为100%,其中Ⅰ期25髋,Ⅱ期44髋,表现为病灶多局限于股骨头前上部分,呈斑片状T1WI低、T2WI压脂高信号区和T2WI压脂"单线征"或"双线征"。④结论 MRI在成人早期ANFH(特别是ARCOⅠ期)诊断中明显优于CT,MRI检查是诊断成人早期ANFH的可靠手段。

Objective To discuss the diagnosis value of CT and MRI in the early avascular necrosis of adult femoral head. Methods By retrospectively analyzing of follow - up diagnosis of 51 cases （ 69 hips ） with the early avascular necrosis of adult femoral head CT and MILl imaging data , analyzed their ability to display and diagnostic capabilities the early avaseular necrosis of adult femoral head. Results 51cases （69 hips） head the performances of early bone necrosis,42 hips were diagnosed the early avascular necrosis of femoral head by CT, the diagnostic accuracy was 60.8% （42/69）, stage 1 6 hips , stage II 36 hips, the main performances were as follows ： the shape of the femoral head was normal, stellatc - shaped structure of trabecular bone was thickening , misshapening,blurred,the femoral head was displayed the point and flake hyperdensity, or the trail shape opeity, 69 hips were diagnosed the early avascular necrosis of adult femoral head by MR/ , the diagnostic accuracy was 100% （69/69） , stage 1 25 hips, stage II 44 hips, The performance limits much for the infection before the femoral head on the part, assumes spot laminated shape TIWI to be low, T2WI presses the fat high signaling zone and T2WI presses the fat ＂the single line sign＂ or ＂the double line sign＂ . Conclusion The diagnosis of MRI in the early avascular necrosis of adult femoral head （ especially ARGO Iperiod） was significantly superior to CT, the MR/examination is a reliable means in the early avascular necrosis of adult femoral head.