股骨头缺血坏死早期CT诊断的临床意义

Clinical significance of early diagnosis of avascular necrosis of the femur head with CT

目的 利用CT进行早期诊断股骨头缺血坏死 (ANFH)并指导临床治疗。方法 对疑诊股骨头缺血坏死的病例均行双髋关节CT扫描 ,找到股骨头坏死的CT早期征像并指导临床治疗。结果 CT早期表现 :2 1例 2 6个股骨头 ,其中 8个股骨头骨小梁呈放射状密度增高的“星状征” ,骨小梁境界清楚、锐利属Ⅰ期 ;18个股骨头表现为骨硬化 ,骨小梁结构消失、模糊不清 ,骨密度减低及囊性改变 ,属Ⅱ期 ;并有 3个股头在Ⅱ期影像改变基础上出现软骨下骨折及轻微塌陷 ,属Ⅲ期。治疗结果 :Ⅰ期行钻孔髓内减压术 ,Ⅱ、Ⅲ期行钻孔减压植骨术。

Objective To diagnose early avascular necrosis of femur head(ANFH) by CT and to guide clinical treatment. Methods The cases with suspicious diagnosis of ANFH were scaned in the both hip joints by CT to find the early CT signs of ANFH. Results Early signs of ANFH using CT showed that, in 26 femoral heads in 21 cases, there were radiate star shape of high-density osteosclerosis of the trabeculae (stage Ⅰ) in 8 femoral head. Eighteen femoral heads showed osteosclerosis and trabeculae structure disappearing and vague, incoordinately low-ostedensity area and cyst change (stage Ⅱ). There were fracture under the cartilage and light subsid in 3 cases (stage Ⅲ). The cases in stage Ⅰ were given decompression, while the pationtsresul in stage Ⅱ and stage Ⅲ were given decompression and ostetransplant. Conclusion CT results show that the sign of the high-osteodensity and low-osteodensity and cyst change can disply early ANFH. It can also instruct the clinical treatment of ANFH.