DCE-MRI评估早期股骨头缺血性坏死介入治疗疗效的研究

Evaluation of the efficacy of interventional therapy for early avascular necrosis of femoral head with DCE-MRI

目的探讨动态对比增强磁共振成像(DCE-MRI)定量参数在评估早期股骨头缺血性坏死(ANFH)介入治疗术后疗效的应用价值。方法选取本院21例单侧股骨头缺血性坏死患者作为观察对象。于介入治疗前、治疗后6个月行髋关节DCE-MRI检查,获取患者病侧与健侧股骨头的容积转移常数(K trans)、组织间隙-血浆速率常数(K ep)和细胞外间隙容积分数(V e)三个灌注参数的比值,评价疗效。结果介入治疗术后,患者病侧与健侧股骨头DCE-MRI扫描参数K trans比值为53.00(33.08,81.17)、K ep比值为6.11(5.11,17.51)、V e比值为5.14(2.76,8.13)明显高于治疗前6.92(3.27,37.11)、3.58(1.97,12.53)、2.43(1.5,4.2),差异有统计学意义(P<0.05)。结论DCE-MRI能够通过定量参数对股骨头缺血性坏死介入治疗疗效进行评估。

Objective To explore the value of dynamic contrastive enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters in evaluating the curative effect of early avascular necrosis of the femoral head(ANFH)after interventional therapy.Methods Twenty-one patients with unilateral avascular necrosis of femoral head admitted in our hospital were selected as observation subjects.DCE-MRI of hip joint was performed before and 6 months after interventional therapy,the ratios of the volume transfer constant(K trans),the constant between tissue clearance and plasma(K ep)and extracellular clearance volume fraction(V e)were obtained from the diseased and healthy sides of the patients to evaluate the efficacy.Results After interventional therapy,the DCE-MRI scan parameter K trans ratio of femoral head was 53.00(33.08,81.17),K ep ratio was 6.11(5.11,17.51),V e ratio was 5.14(2.76,8.13),which was significantly higher than before treatment 6.92(3.27,37.11),3.58(1.97,12.53),2.43(1.5,4.2),the difference was statistically significant(P<0.05).Conclusion DCE-MRI can evaluate the efficacy of interventional therapy for avascular necrosis of the femoral head through quantitative parameters.