SARS康复者股骨头缺血坏死的MRI随访

Osteonecrosis of the femoral head in recovered SARS patients:follow-up with MR imaging

目的 明确SARS康复者股骨头缺血坏死的发生率和影像表现。方法 对 43例SARS康复者的 86个股骨头进行MRI普查和数字摄影平片检查。结果 86个股骨头中 ,2 2个 (2 6%)发生了缺血性骨坏死 ,其中Ⅰ期 16个、Ⅱ期 5个、Ⅲ期 1个。MRI上 91%(2 0 / 2 2 )的股骨头坏死表现为典型的“双线征”改变 ,而仅有 14 %(3 / 2 2 )显示骨髓广泛水肿。数字平片仅能发现 2 7%(6/ 2 2 )的股骨头坏死。有髋关节症状组和无髋关节症状组对照发现 ,两组股骨头坏死率没有统计学差别。结论 不管有无髋关节症状 ,SARS康复者股骨头缺血坏死的发生率均较高 ,对这些患者进行合理的MRI随访是非常必要的。

Objective To determine the incidence and imaging appearance of femoral head osteonecrosis in patients recovering from severe acute respiratory syndrome (SARS). Methods MR images and digital radiographies of the femoral head were obtained from 43 patients (86 hips) after they had been discharged from hospital for 8-9 months. Results Twenty-two femoral heads (26%) were diagnosed osteonecrosis on the basis of MR images,including 16 of stage Ⅰ,5 of stage Ⅱ,and 1 of stage Ⅲ. 91% (20/22) osteonecrotic femoral heads had the typical pattern of ”double-lines” sign,and only 14% (3/22) had the pattern of diffuse bone marrow edema in MR images. Only 27% (6/22) abnormal femoral heads diagnosed by MR images were diagnosed correctly by digital radiography. There were no statistical discrepancy of incidence of osteonecrosis between symptomatic hips and asymptomatic hips. Conclusion Relatively high incidence of the femoral head osteonecrosis was found in recovered SARS patients. It is important to arrange reasonable serial MRI follow-up for this kind of patients.