股骨头缺血性坏死的影像学分析

Clinical analysis of the imaging feature in patients with femoral head necrosis

目的探讨股骨头缺血性坏死(ANFH)的X线、CT表现及临床价值。方法回顾性分析36例ANFH患者影像学资料,并进行总结比较。结果 36例中双侧发病13例,占36%;单侧发病23例,占64%。X线检查:股骨头未发现异常6例,诊断为Ⅰ期1例,Ⅱ期9例,Ⅲ期12例,Ⅳ期8例;CT检查:股骨头未发现异常1例,CT诊断为Ⅰ期4例,Ⅱ期8例,Ⅲ期15例,Ⅳ期8例。结论 X线片是诊断ANFH最基本、最经济、最简便的方法,但对早期病变易漏诊,对中、晚期AFHN可明确诊断。CT具有较高的分辨率,能显示病理Ⅱ期ANFH,对于ANFH的早期诊断和分期比X线片优越。

Objective To explore the imaging feature of X-ray and CT in patients with femoral head necrosis. Methods We reviewed the data of 36 cases with femoral head necrosis. Results In all 36 cases,13 cases with two sides necrosis,occupied 36%. Twenty-three cases with one side necrosis,occupied 64%. In all X-ray findings, 6 cases were normal,1 case was in stage Ⅰ, 9 cases were in stage Ⅱ,12 cases were in stage Ⅲ,8 cases were in stage Ⅳ. In CT features ：only one case without femoral head necrosis. Four cases were in stage Ⅰ ,8 cases were in stage Ⅱ,15 cases were in stage 111,8 cases were in stage Ⅳ. Conclusion It＇s a basic simply method to diagnose avascalar necrosis of femoral head by X-ray findings, while it＇s easy to misdiagnose the early stage avasular necrosis of femoral head. It＇s better for the middle stage and late stage. There＇s advantage in diagnosing early ANFH and stage Ⅱ in pathological by CT than X-ray for the high resolation of CT.