| 早期股骨头坏死影像表现特点及鉴别诊断 |
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摘要点击次数: 2710
全文下载次数: 1397
投稿时间：2009-12-23
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| 期刊信息：《中国骨伤》2010年，第23卷，第5期，第344-348页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.008 |
| 基金项目:“十一五”国家科技支撑计划项目(编号:2007BAI20B035) |
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中文摘要:
目的：研究早期股骨头坏死影像学表现特点，为临床鉴别诊断和治疗方案的选择提供客观依据。
方法：回顾性分析2007年3月至2008年6月收治经临床与MRI检查确诊为股骨头坏死，ARCO分期Ⅰ、Ⅱ期的患者91例。其中男32例，女59例；年龄21～60岁，平均(34.83±9.57)岁；单侧17例，双侧74例；激素性48例，酒精性35例，原因不明8例；病程2～12个月。分析其X 线、CT、MRI影像学表现，总结、归纳其变化特点并与髋关节类骨坏死疾病影像表现相鉴别。
结果：91例股骨头坏死形态中均可见T1WI像上股骨头负重区线样低信号，T2WI像上为高信号的“双线征”,但形态各有特点，线条样为36例(39.56%),椭圆形28例(30.77%),地图形14例(15.38%),楔形13例(14.29%).类骨坏死疾病包括原发性髋骨性关节炎、发育性髋关节炎、股骨头骨骺炎(扁平髋)、类风湿性髋关节炎、强脊性髋关节炎、髋关节一过性滑膜炎、股骨头骨髓水肿等，其X线也具有囊变、关节间隙变窄、股骨头变形等与股骨头坏死类似的表现，但MRI的表现则有各自的特点。
结论：掌握早期股骨头坏死的影像表现特点，有利于与髋关节类骨坏死疾病相鉴别，早期明确诊断，制定不同的治疗措施。 |
| 【关键词】股骨头坏死 放射摄影影像解释,计算机辅助 诊断,鉴别 |
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| Radiographic imaging feature and differential diagnosis of early femoral head necrosis |
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ABSTRACT
Objective: To study early femoral head necrosis radiographic imaging features to provide objective basis for the clinical differential diagnosis and therapeutic schedule's choice.
Methods: Ninty-one patients with femur head necrosis of ARCO stageⅠand Ⅱ whom were diagnosed by clinic and MRI and treated from March 2007 to June 2008 were analyzed retrospectively. There were 32 males and 59 females with an average age of(34.83±9.57) years ranging from 21 to 60 years. The course of disease were from 2 to 12 months. There were 17 cases of unilateral and 74 of bilateral; 48 cases caused by steroid,35 cases by alcohol and 8 cases for unknown reasons. The images of X-ray,CT and MRI of femoral head were analyzed to summarize the characteristic and to distinguish with the imaging of similar osteonecrosis.
Results: Ninety-one cases had linear low signal on T1WI in weight-bearing area of femoral head and high signal of the “dual taxation” on T2WI. But the shapes had different characteristics. There were 36 cases (39.56%) of line type shapes,28 cases(30.77%) of oval shapes,14 cases (15.38%) of map-like shapes,13 cases(14.29%) of wedge shapes. The X-rays of the disease similar to bone necrosis including primary hip osteoarthritis,developmental dysplasia of hip arthritis,femoral head epiphysitis(coxa plana),rheumatoid hip arthritis,hip arthritis of ankylosing spondylitis,transitional synovitis of hip joint,femoral head bone marrow edema etc,had the similar performance to femur head necrosis like cystic changes,joint space narrowing,femoral head deformation. MRI performance had their own characteristics.
Conclusion: Mastering the image features of the early femoral head necrosis will help the early diagnosis and treatment of hip joint necrosis disease. |
| KEY WORDS Femur head necrosis Radiographic image interpretation,computer-assisted Diagnosis,differential |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘吉鹏,张书钦,陈卫衡.早期股骨头坏死影像表现特点及鉴别诊断[J].中国骨伤,2010,23(5):344~348 |
| 英文格式: | LIU Ji-peng,ZHANG Shu-qin,CHEN Wei-heng.Radiographic imaging feature and differential diagnosis of early femoral head necrosis[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):344~348 |
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