摘要
对２９例３６髋怀疑或确诊为股骨头缺血性坏死的病人进行了ＭＲＩ检查，其中３３髋有阳性发现。依据ＭＲＩ影像学特征，将股骨头缺血性坏死分为４型。Ａ型：其特点为包绕在代表硬化反应缘的低信号带以内的病变区显示如同正常的脂肪样信号，即Ｔ１ＷＩ为高信号，而Ｔ２ＷＩ为中高信号，形成“双线征”，此为早期股骨头缺血性坏死的特征性改变。Ｂ型：即在Ｔ１ＷＩ及Ｔ２ＷＩ坏死区均表现为类似亚急性血肿的高信号，表明股骨头缺血性坏死的修复过程已开始，坏死区有大量的毛细血管增生。Ｃ型：当股骨头内的脂质成分由于被修复过程中增生的肉芽组织替代而减少或由于修复反应造成坏死区水肿时，ＭＲＩ表现为Ｔ１ＷＩ低信号，Ｔ２ＷＩ高信号。Ｄ型：即Ｔ１ＷＩ及Ｔ２ＷＩ均表现为低信号，表明坏死区完全成为纤维组织或硬化骨组织，是股骨头缺血性坏死晚期的表现。ＭＲＩ的分型与股骨头缺血性坏死的Ｘ线分期有密切的联系，而与髋关节临床功能不表现显著的相关性。ＭＲＩ在诊断早期股骨头缺血性坏死及判定缺血性坏死的程度，指导临床治疗方面有极为重要的价值。
Twentyninepatientswith36hipssuspectedofordiagnosedasavascularnecrosisofthefemoralhead(ANFH)wereexaminedwithMRI.Thepositiveresultsweredemonstratedin33hips.FourtypesofANFHareclassifiedaccordingtotheircharacteristicsofMRI.TypeA,thefatlike,exhib-itednormalfatsignal,exceptatthescleroticreactivemarginsurroundingthelesion,whichshowslow-intensitysignal.This“doublelinesign”isthefeatureofearlyANFH;typeB,thebloodlike,hashigh-in-tensitysignalonbothT1WIandT2WIthataresimilartosubacutehemorrhage.Itindicatesthebegin-ningoftherepairprocessofANFHandwithlargenumberofcapilaryproliferationinthenecroticre-gion;typeC,thefluidlike,hasgranulationtissueoredemaofnecroticareaanddecreaseofthelipidcon-tentofthefemoralhead.Low-intensitysignalonT1WIandhigh-intensitysignalonT2WIcanbeob-served;typeD,thefibrouslike,hasfibrosisandsclerosisinthenecroticarea,bothT1WIandT2WIshowlow-intensitysignal;thisisthecharacteristicsoflaterstageofANFH.Thereiscloserelationshipbe-tweenMRIpaternandradiographicstageonANFH,butnocorrelationwiththefunctionofthehip.MRIishighlyvaluableforthedeterminationofearlyANFHofthedegreesofANFH.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第8期485-488,共4页
Chinese Journal of Orthopaedics
