摘要
目的应用核磁共振成像（MRI）技术观察运动对早期激素性股骨头坏死的影响。方法24只新西兰大白兔随机分为对照组（A组）、常模组（B组）、运动组（c组），每组8只，A组每只每天臀部肌肉注射等量生理盐水，B、c组每只每天臀部肌肉注射醋酸地塞米松2．5mg／kg造模，C组同时给予中等强度运动，分别于第2、4、6、8周对双侧股骨头及其内侧冠状面软组织像内直径为3mm的圆形定点区域进行MRI影像学分析。结果髋关节周围软组织区内MRIt2-de3d-sag信号强度第2、4、6、8周A组为56．26±0．45、58．05±0．27、59．04±0．29、59．23±0．25，B组为61．40±0．41、63．71±0．34、69．65±0．28、71．84±0．3，C组为59．54±0．39、60．06±0．32、62．71±0．19、63．18±0．40，3组间差异显著（F=84．93，P〈0．05）；B、C组信号强度随时间延长逐渐增高，与A组各期比较差异显著；B组的第4、6、8周与第2周之间差异显著；C组的第6、8周分别与第2、4周之间差异显著（P〈0．05）；第6周时B组信号强度的95％可信区间为69．96-73．77。B组从第4周开始部分动物出现股骨头坏死的影像学改变，股骨头信号强度不均，关节腔内信号改变，T1WI信号灰度值降低，T2WI呈不均匀高信号，而C组第6周才出现部分动物股骨头坏死影像学改变，各组间比较差异显著（F=19．24，P〈0．05）。结论激素性股骨头坏死发病的始动机制可能是髋关节周围软组织的炎性水肿；运动可减轻早期激素性股骨头坏死髋关节周围软组织的水肿，延缓股骨头坏死进展。当实验兔髋关节周围软组织MRI t2-de3d-sag序列信号强度达到69．96～73．77时，即可诊断为0期激素性股骨头坏死。
Objective To observe the effects of exercises on early stage of steroid-induced necrosis of the femoral head in rabbits with magnetic resonance imaging （MRI）. Methods 24 adult rabbits were divided randomly into three groups, i.e. control group （group A）, routine model group （group B） and experimental group （group C） with 8 animals for each group. Dexamethasone （DXM） was administra- ted in a dosage of 2. 5mg/kg via intramuscular route to reproduce the aseptic necrosis of femoral head （ANFH） model in groups B and C, while only isotonic physiological saline was given to the animals in group A. MRI examinations were done at 2nd, 4th, 6th and 8th week after administration of DXM for bilateral femoral heads, and also on a medial coronary area of the hip joints with a fixed area of circumambient soft tissure of 3 mm in diameter. Results At 2nd, 4th, 6th and 8th week after the reproduction of the model, the t2-de3d-sag spot- signals given by MRI in the circumambient soft tissue of hip joints were 56. 26±0. 45, 58. 05±0. 27, 59. 04±0. 29 and 59. 23±0. 25 in group A, 61.40±0. 41, 63. 71±0. 34, 69. 65±0. 28 and 71.84±0. 3 in group B, and 59. 54±0. 39, 60. 06±0. 32, 62. 71±0. 19 and 63. 18±0. 40 in group C, respectively. Significant differences existed between each of two groups （F=84.93, P〈0. 05 ）. The spot-signals intensity increased with the lapse of time in both groups of B and C, and there were significant differences from that of group A （P〈0. 05）. For group B, there were significant differences in signal intensity at the 4th, 6th, 8th week as compared that of the 2nd week, and for group C there were significant differences in the intensity at the 6th and 8th compared with that of the 2nd and 4th week （P〈0. 05）. The 95~ confident interval of MRI t2-de3d-sag spot-signals in group B was 69. 96~73. 77 at the 6th week. Certain image changes in femoral head necrosis appeared in some of the rabbits in group B at the 4th week. Uneven signal intensity was observed in the femoral head, signals of changes appeared in the joint cavity, the gradation value of T1WI signal declined, and T2WI assumed non-uniform high signal. However, no image change in femoral head necrosis was found until the 6th week in group C. Significant differences existed among each of two groups （F= 19. 24, P〈0. 05）. Conclusion The pathogenesis of ANFH might be attributed to the inflammatory edema of the surrounding soft tissues of the hip joint. Adequate exercises may alleviate the inflammatory edema and retard the development of early ANFH. 0 stage of ANFH can be diatmosed when MRI t2-de3d-sag spot-signals reached to 69. 96 73. 77.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2006年第4期297-299,共3页
Medical Journal of Chinese People's Liberation Army
基金
全军医学科研基金重点课题(04LX010)
关键词
运动
股骨头坏死
磁共振成像
exercise
femoral head necrosis
magnetic resonance imaging
