摘要
目的动态对比增强磁共振成像(DCE-MRI)与股骨头坏死(ONFH)患者病程进展关系及对疗效的评估价值。方法选取ONFH患者83例,均接受髓芯减压植骨治疗,根据术后3个月Harris髋关节功能评分量表(HHS)评分分为有效组(n=57)与无效组(n=26)。比较两组基线资料、病程进展[国际骨循环协会(ARCO)分期、髋关节积液分级、骨髓水肿分级]、DCE-MRI参数[容量转移常数(K^(trans))、速率常数(K_(ep))、初始时间-浓度曲线下面积(iAUC)],分析DCE-MRI参数与病程进展的相关性,评价ONFH疗效评估影响因素,探讨DCE-MRI对ONFH疗效的评估价值。结果K^(trans)、K_(ep)、iAUC组间比较,无效组>有效组(P<0.05);K^(trans)、K_(ep)、iAUC与ARCO分期、髋关节积液分级、骨髓水肿分级均呈正相关(P<0.05);将ARCO分期、髋关节积液分级、骨髓水肿分级等其他因素控制后,K^(trans)、K_(ep)、iAUC与ONFH治疗无效(HHS评分)显著相关(P<0.05);K^(trans)、K_(ep)、iAUC联合评估ONFH治疗无效的曲线下面积(AUC)优于单一评估,为0.928。结论DCE-MRI参数K^(trans)、K_(ep)、iAUC与ONFH患者病程进展密切相关,采用DCE-MRI检查有望为临床选择治疗方案、治疗效果评价提供循证支持。
Objective The correlation between dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and the progression of the disease course of patients with osteonecrosis of the femoral head(ONFH)and the evaluation value of curative effect.Methods 82 patients with ONFH were selected and all received core decompression and bone grafting.According to the Harris Hip Function Score Scale(HHS),3 months after operation,they were divided into effective group(n=57)and ineffective group(n=26).The baseline data;disease progression indexes,including International Bone Circulation Association(ARCO)staging,hip joint effusion grade,and bone marrow edema grade;and DCE-MRI parameters,including volume transfer constant(K^(trans)),rate constant(K_(ep)),initial time-area under the concentration curve(iAUC);were compared between the 2 groups.The correlations between DCE-MRI parameters and the progression of the disease were analyzed.The influencing factors on ONFH curative effect evaluation was further analyzed.The evaluation value of DCE—MRI on the curative effect of ONFH was also anzlyed.Results K^(trans),K_(ep),and iAUC were significantly higher in ineffective group thanb effective group(P<0.05).K^(trans),K_(ep) and iAUC were significantly positively correlated with ARCO staging,hip effusion grade,and bone marrow edema grade(P<0.05).After controlling for other factors such as ARCO staging,hip effusion grade,and bone marrow edema grade;K^(trans),K_(ep),iAUC and ONFH treatment failure(HHS score)were significantly correlated(P<0.05).The combined diagnosis of K^(trans),K_(ep) and iAUC for ONFH treatment failure was significantly better than single evaluation.Conclusion The DCE-MRI parameters K^(trans),K_(ep),and iAUC are closely correlated to the progression of ONFH patients.The use of DCE-MRI examination is expected to provide evidence-based support for clinical selection of treatment and efficacy evaluation.
作者
陈绍宁
魏冰
CHEN Shao-ning;WEI Bing(Department of Radiology,Yongkang Orthopaedic Hospital,Yongkang 321300,Zhejiang,China;不详)
出处
《广东医学》
CAS
2022年第2期226-230,共5页
Guangdong Medical Journal
关键词
动态对比增强磁共振成像
股骨头坏死
病程进展
疗效
髋关节积液分级
骨髓水肿分级
dynamic contrast enhanced magnetic resonance imaging
femoral head necrosis
course progress
curative effect
grading of hip joint effusion
grading of bone marrow edema
