MRI对股骨颈骨折术后并发股骨头坏死早期诊断的临床研究

Clinical research of MRI in the early diagnosis of transcervical fracture postoperative osteonecrosis of the femeral head

目的 探讨MRI对股骨颈骨折术后并发股骨头坏死早期诊断的影响。方法 随机选取2011年5月-2012年12月我院股骨颈骨折术后并发股骨头坏死患者65例,对所有患者皆进行MRI及X线片影像学检查。分析不同时期的诊断敏感性,并对其股骨头坏死进展情况进行比较。结果 MRI检查在3个月内敏感性为20.00%,4-6个月敏感性为24.62%,7-9个月敏感性为32.31%,10-12个月为26.15%,均显著高于X线片检查结果（7.69%、9.23%、20.00%、7.69%）,两组比较,差异有统计学意义（P〈0.05）;而13-18个月及≥19个月检出率,两组比较,差异无统计学意义（P〉0.05）。MRI随时间变化的股骨头坏死进展,放射前期到骨关节炎期所需发现时间随疾病的进展而增加,差异有统计学意义（P〈0.05）。结论 股骨颈骨折术后3个月即可接受常规MRI检查,预防股骨头坏死的发生,适合于临床推广应用。

Objective To explore the effect of MRI in the early diagnosis of transcervical fracture postoperative osteonecrosis of the femeral head. Methods 65 cases of transcervical fracture postoperative osteonecrosis of the femeral head in our hospital from May 2011 to December 2012 were randomly selected,and all patients were performed MRI and X-ray imaging.The different periods of sensitivity and progress of osteonecrosis of the femeral head along with the time change were all observed and compared. Results The sensitivity of MRI examination in 3 months,4-6 months,7-9months,10-12 months was 20.00%,24.62%,32.31%,26.15%,which were significantly higher than those for X-ray examination results（7.69%,9.23%,20.00%,7.69%）,the differences were statistically significant between the two groups（P〈0.05）;while in the detection rate of 13-18 months and ≥19 months,there were no significant differences between the two groups（P〉0.05）.In the progress of ONFH along with the time change in MRI,the desired discovery time from radiation pre to osteoarthritis increased with the progression of the disease,the difference was statistically significant（P〈0.05）. Conclusion The routine MRI examination can be implemented in 3 months after the operation of transcervical fracture,to exclude the possibility of complicated with osteonecrosis of the femeral head.