摘要
目的通过对股骨头坏死范围指数的MRI测量,旨在探讨MRI预测股骨头坏死塌陷的价值。方法我们选择43例股骨头坏死病例(57个股骨头),初诊均为ARCO分期的Ⅰ、Ⅱ期。所有病例做冠状定位,SE序列横断位、冠状位、矢状位T1加权,FSE序列横断位及冠状位T2加权,IR序列矢状位扫描。在MRI的中部冠状位和矢状位图像上分别测量坏死角度,根据公式计算坏死范围指数。坏死范围指数分级:A级(指数小于33);B级(33~66);C级(大于66)。随访时间3~46个月。结果经过随访,57个股骨头坏死中有41个发生了塌陷。原Ⅰ期的25个股骨头坏死,有16个股骨头发生了塌陷,5个进展为Ⅱ期,仅有4个停留在Ⅰ期。原Ⅱ期32个股骨头坏死,有25个发生了塌陷,其他7个停留在Ⅱ期。随访后,原Ⅰ期的股骨头坏死进展率为84%。原Ⅱ期的股骨头坏死进展率为78%。坏死范围指数的分组:低危险组(指数小于30)塌陷的危险率为0,无1例塌陷;中等危险组(指数30~42)塌陷的危险率为50%;高危险组(指数大于42)塌陷的危险率为100%。结论MRI测量的坏死范围指数是预测股骨头坏死塌陷的简易可靠的方法。
Objective To study the value of MR imaging for prognosis in patients with avascular necrosis of femoral head （ANFH）. Methods Fifty-seven heads of stage Ⅰor Ⅱ osteonecrosis of the femoral heads in 43 patients underwent MR examination. ARCO＇s classification for radiographs was adopted. In all patients, SE T1WI was obtained in the axial, coronal, sagittal plane, and FSE T2WI in axial, coronal plane and IR sequence in coronal plane. Middle coronal and sagittal T1WI was used to divided the index of necrotic extent： grade A （with a necrotic portion≤33 %）; grade B （33 % -66% ）;grade C （〉66%）. Results Of the 25 hips that had been classified as stage Ⅰ at the initial examination, 16 had collapsed, 5 progressed to stage Ⅱ. Of the 32 hips that had been classified as stage Ⅲ, 25 had collapsed. After following-up, 41 of the 57 hips had collapsed. The rate of radiological progression was 84% in stage Ⅰ , 78% in stage Ⅱ. The collapse rate for three groups of the index of necrotic extent was 0 （index^30）, 50% （index 30-42）, 100% （index〉42） respectively. Conclusion MRI could predict the rate of collapse of ANFH, and the index of necrotic extent on MRI was more accurate than others.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第4期594-596,共3页
Chinese Journal of Medical Imaging Technology
