比较CT与磁共振技术在股骨头坏死诊断中的临床价值

Compare the Clinical Value of CT and MRI in the Diagnosis of Femoral Head Necrosis

目的:对比CT与磁共振技术(MRI)在股骨头坏死(ONFH)诊断中的临床效果。方法:选取我院2020年4月-2021年3月就诊的股骨头坏死患者136例纳入本次研究,根据诊断方法将其分为2组,对照组68例接受CT诊断,观察组68例行MRI检测,对比2组患者检出率、诊断正确率和影像学特征。结果:观察组Ⅰ期、Ⅱ期检出率高于对照组,组间差异显著(P<0.05);2组患者Ⅲ期、Ⅳ期检出率相近,组间差异无统计学意义(P>0.05);观察组总检出率高于对照组,组间差异显著(P<0.05)。观察组诊断准确率为97.06%,高于对照组的69.12%,组间差异显著(P<0.05)。Ⅰ期患者对照组检测结果为阴性,观察组可见局部线条异常;Ⅱ期观察组患者T1W1像下可见股骨头边缘处呈现楔形或条索状混合信号,对照组患者骨小梁可见增粗或星芒状变形异常;Ⅲ期观察组患者T1W1像下可见新月状,呈现不规则低信号区,对照组患者可见股骨头局部塌陷;Ⅳ期观察组患者可见关节退行性病变,T1W1像下大面积低信号区,对照组患者可见关节缝隙变窄,关节软骨损伤严重,关节面扁平,股骨头结构改变明显。结论:相对于CT检测,MRI在股骨头坏死诊断中的准确率更高,可以为临床筛查和治疗提供有利依据,值得临床推广使用。

Objective:Compare the clinical effects of CT and magnetic resonance imaging(MRI)in the diagnosis of osteonecrosis of the femoral head(ONFH).Methods:136 patients with osteonecrosis of the femoral head in our hospital were selected and included in this study(sample collection time:April 2020-April 2021).They were divided into two groups according to the diagnostic method.68 patients in the control group received CT diagnosis,and 68 patients in the observation group received MRI detection.The detection rate,diagnostic accuracy and imaging characteristics of the two groups were compared.Results:(1)The detection rate of phase Ⅰ and Ⅱ in the observation group was higher than that in the control group,and the difference was significant(P<0.05).There was no significant difference between the two groups(P>0.05).The total detection rate in the observation group was higher than that in the control group,and the difference was significant(P<0.05);(2)The diagnostic accuracy of the observation group(97.06%)was higher than that of the control group(69.12%).There was significant difference between the two groups(P<0.05);(3)Stage I:The test results of the control group were negative,and local line abnormalities were observed in the observation group.Stage Ⅱ:In the observation group,wedge-shaped or strip-shaped mixed signals can be seen at the edge of the femoral head under T1W1 image.In the control group,the bone trabeculae were thickened or star shaped deformed abnormally;Stage Ⅲ:Crescent shaped,irregular low signal area can be seen under T1W1 image in the observation group.In the control group,local collapse of femoral head was observed;Stage Ⅳ:In the observation group,there were joint degenerative lesions and a large area of low signal area under T1W1 image.In the control group,the joint gap became narrower,the articular cartilage was seriously damaged,the articular surface was flat,and the femoral head structure changed significantly.Conclusion:Compared with CT,MRI has a higher accuracy in the diagnosis of femoral head necrosis,which can provide a favorable basis for clinical screening and treatment,and is worthy of clinical promotion.