ARCO 2-4期股骨头坏死MR征象对Harris评分影响分析

Analysis of influence of MR signs on Harris score in ARCO stages 2-4 femoral head necrosis

目的:分析并确定ARCO 2-4期股骨头坏死(osteonecrosis of femoral head,ONFH)对Harris评分有影响意义的MR征象。方法:回顾性分析2019年1月至2020年6月34例行常规MR、T2 mapping、3D-SPACE序列检查及Harris评分的ARCO 2-4期ONFH患者,排除3例,最终纳入31例,男23例,女8例,年龄18~62(40.0±10.8)岁;其中21例为双侧ONFH,共计52个ONFH,ARC02期17个,ARCO 3期24个,ARCO 4期11个。在医院数字影像信息系统(picture archiving and communication system,PACS)对MR影像征象(股骨头塌陷深度、ONFH指数、骨髓水肿、股骨头骨质增生、软骨损伤分级、软骨T2值及关节积液)进行评估及测量,在Siemens后处理工作站计算软骨定量参数T2值并测量。采用Pearson相关分析评估MR各征象与Harris评分的相关性,采用多重线性回归分析评估与Harris评分有相关性的MR征象对Harris评分的影响。结果:Pearson相关分析显示股骨头塌陷深度(r=-0.563,P=0.000)、软骨损伤分级(r=-0.500,P=0.000)及关节积液(r=-0.535,P=0.000)与Harris评分呈负相关。多重线性回归分析显示关节积液(β=-6.198,P=0.001)、股骨头塌陷深度(β=-4.085,P=0.014)对Harris评分呈负相关。结论:关节积液、股骨头塌陷深度对Harris评分有显著的负向影响关系,建议影像医师常规对股骨头塌陷深度、关节积液进行定量及等级评估,以高效精准地辅助临床诊疗。

Objective To analysis and determine MR signs of Harris score ARCO stages 2-4 in osteonecrosis of femoral head(ONFH).Methods Thirty-four patients with ONFH of ARCO stages 2 to 4 who underwent routine MR,T2 mapping,3DSPACE sequence examination and Harris score were retrospectively collected from January 2019 to June 2020,and 3 patients were excluded,and 31 patients were finally included,including 23 males and 8 females,aged from 18 to 62 years old with an average of(40.0±10.8) years old.Among them 21 patients with bilateral femoral head necrosis,totally 52 cases,including 17with ARCO stage 2 patients,24 ARCO stage 3,and 11 ARCO stage 4.MR imaging signs(femoral head collapse depth,ONFH index,bone marrow edema,hyperplasia,grade and T2 value of cartilage injury,and joint effusion) were scored and measured on the picture archiving and communication system(PACS) workstation,and the cartilage quantitative parameter T2 value was calculated and measured on Siemens postprocessing workstation.Pearson correlation analysis was used to evaluate the correlation between various MR signs and Harris score,and then multiple linear regression analysis was used to examine impact of MR signs on Harris hip score.Results Femoral head collapse depth(r=-0.563,P=0.000),grade of cartilage injury(r=-0.500,P=0.000),and joint effusion(r=-0.535,P=0.000) were negatively correlated with Harris score by Pearson correlation analysis.Multiple linear regression analysis showed that joint effusion(β=-6.198,P=0.001) and femoral head collapse depth(β=-4.085,P=0.014) had a significant negative impact on Harris hip score.Conclusion Femoral head collapse depth and joint effusion both had significant negative relationship with Harris hip score.It is recommended to routinely evaluate femoral head collapse depth and joint effusion quantitatively and gradedly,so as to efficiently and accurately assist clinical diagnosis and treatment.