摘要
目的 探讨股骨头缺血坏死（ANFH）影像学表现对应的病理改变.方法 收集北京中日友好医院15位患者的20个坏死股骨头普通平片、CT、MRI表现与大体切片、组织病理做对照研究.结果 ANFH均累及股骨头前部的外上方,大体标本上坏死股骨头由软骨、坏死区、周围的增生反应区和病灶外正常区组成,增生反应区包绕坏死区.影像学改变：①坏死区在平片和CT上表现为等密度11个、低密度7个、稍高密度2个,MRI上股骨头坏死区3个呈脂肪样信号、1个呈血液样信号、2个为水样信号、9个呈纤维样信号、5个呈混杂信号.②增生反应区分隔坏死区和正常区,于平片和CT上呈高密度硬化带,其中CT、平片分别显示12个和7个股骨头于硬化带内侧见伴行的低密度透光带 MRI上增生反应区于T1WI和T2WI上均呈低信号,其中3个股骨头于T2WI上见双线征.结论 平片、CT、MRI能准确地显示ANFH大体标本上的坏死区、增生反应区和病灶外正常区,ANFH特征性影像学改变在病变的增生反应区.
Objective To investigate the relationship between imaging and pathological findings of avascular necrotic of the femoral head（ANFH）.Methods A comparison among of conventional radiography, computerized tomography（CT）, magnetic resonance imaging（MRI）, gross section and pathological examinations was performed in 20 femoral heads in 15 patients undergoing total hip replacement for established ANFH.Results ANFH involved the anterosuperior aspect of femoral head in all hips.Necrotic femoral heads consisted of cartilage, necrotic area, reactive repaired area and extralesional area. The reactive repaired area surrounded necrotic area. Imaging findings ① on conventional radiography and CT, as compared with the extralesional area, the necrotic area appeared to be of an equal density（11）,a lower density（7）and a higher density（2）On MRI, the necrotic areas revealed adipose intensity（3）, bloodlike intensity（1） , aquatic intensity （2） ,fibrous intensity （9） and non-homogeneous intensity（5） ②the reactive repaired area separated the necrotic and extralesional areas.Both on plain radiography and CT,the reactive repaired area showed a sclerotic band surrounding the necrotic area and a hypo-density inner line adjacent to sclerotic band was seen in 11 femoral heads on CT and 7 on conventional radiography.A band of low signal in the proliferative zone was seen on MRI in all hips and a rim of high signal intensity inside the low-signal margin（double-line sign）was seen in 3 hips on T2W images.Conclusion Conventional radiography, CT and MRI can display the grossly discernable necrotic, reactive repaired and extralesional areas accurately.Characteristic imaging findings are observed in the reactive repaired area.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第39期2745-2749,共5页
National Medical Journal of China
