成人早期股骨头缺血性坏死的影像学诊断价值

目的探讨成人早期股骨头缺血性坏死(ANFH)的影像学(X线平片,CT及MRI)诊断价值。方法选择影像学检查结合临床资料确诊的病例,比较分析25例34个早期股骨头缺血性坏死的X线平片,CT及MRI的诊断结果。结果34个早期股骨头缺血性坏死中,Ⅰ期13髋,Ⅱ期21髋。早期(Ⅰ~Ⅱ期)股骨头坏死的X线平片,CT及MRI的确诊率分别是32.4%,61.8%及100%。结论MRI与其它影像检查方法相比能够更早发现病变,且敏感性和准确率高于CT和X线平片。     

高原地区成人股骨头缺血性坏死X线及CT影像诊断价值

目的 探讨X线及CT影像检查在高原地区成人股骨头缺血性坏死不同时期诊断中的应用价值。方法 回顾性收集2013年10月至2021年1月于我院经手术病理证实为股骨头缺血坏死临床及影像资料,所有患者均有完整的骨盆X线检查及CT影像资料。由2名多年影像诊断经验放射科医生共同阅片分别对比骨盆X线和CT影像图像进行分期,比较X线及CT检查股骨头分期的准确性。结果 据纳入及排除标准最终纳入44例（88髋）;X线及CT检查对股骨头缺血坏死的准确率分别为87.5%、96.6%,差异有统计学意义（χ2=4.97,P=0.03）。CT对股骨头缺血坏死Ⅰ期和Ⅱ期准确率明显高于X线,差异有统计学意义（P<0.05）,对Ⅲ期CT准确率略高于X线,但差异无统计学意义（P>0.05）,Ⅳ期两者准确率均达到100%。结论 Ⅰ期和Ⅱ期股骨头缺血坏死CT准确率明显高于X线检查,X线检查结果阴性患者如果临床高度可疑股骨头缺血坏死,应需要进一步CT检查。     

股骨头缺血性坏死的CT/MRI特征性表现比较分析

目的:探讨CT/MRI特征表现在股骨头缺血坏死中的诊断价值.方法:分析和总结60例86髋经临床确诊为股骨头缺血性坏死的影像学资料.全部病例均同期行MRI、CT检查.结果:①18个早期病变中,CT示10个表现骨小梁结构模糊,16个表现单纯高密度硬化;MRI示15个出现骨髓水肿,13个有“线样征”;②68个中晚期病变中,股骨头骨小梁断裂及皮质塌陷,CT 45个,MRI 30个(P＜0.01);髋臼病变并骨质疏松,CT 49个,MRI 35个(P＜0.01).MRI显示51个关节积液.其他影像学表现两者类似.结论:骨髓水肿,“线样征”是早期股骨头缺血性坏死MRI特征性表现.骨小梁结构模糊、中断、碎裂骨折、皮质塌陷及骨质疏松改变CT优于MRI.     

早期成人股骨头缺血坏死的对比影像学诊断研究

目的：探讨早期成人股骨头缺血坏死（FHN）的MRI、CT、单光子发射计算机体层摄影（SPECT）和DR 4种影像学检查方法之间的对应关系及其敏感性,建立早期诊断的影像学检查途径。方法：分析和总结22例30髋随访具有典型影像学表现的早期（ARCOⅠ～Ⅱ期）成人FHN患者的髋关节影像学资料。全部病例均行同期MRI、CT、SPECT、DR检查。结果：MRI 30髋出现“线样征”,其中15髋为“单线征”,15髋为“双线征”;CT上对应部位显示为较模糊的高密度硬化线14髋,硬化线下伴行低密度带7髋;高密度硬化斑点5髋;SPECT上股骨头呈环形和弧形放射性浓聚带23髋,DR上模糊硬化条带13髋。结论：MRI上“线样征”、CT上承重区高密度硬化线和硬化线下低密度带,SPECT上股骨头环形和弧形放射性浓聚带以及DR片上模糊硬化带相互对应为诊断早期FHN的特异性征象。综合比较对早期成人FHN诊断的敏感性MRI最高。     

成人早期股骨头缺血性坏死的X线、CT及MRI诊断价值

目的 探讨成人早期股骨头缺血性坏死(ANFH)的X线、CT及MRI诊断价值.方法 回顾性分析经临床确诊的63例75个早期股骨头缺血性坏死的X线平片、CT及MRI的诊断结果.结果 75个早期ANFH中, Ⅰ期30髋;Ⅱ期45髋;早期(Ⅰ～Ⅱ期)股骨头坏死的X线平片、CT及MRI的确诊率分别是25.3%, 64%及100%.结论 MRI在早期诊断ANFH的敏感性和准确率方面优于CT和X线平片.     

股骨头缺血性坏死的CT表现(附86例报告)

目的:探讨股骨头缺血性坏死的CT表现.方法:利用螺旋CT对疑有股骨头坏死的86例患者进行扫描.结果:86例患者发现107个股骨头出现缺血性坏死,并表现股骨头缺血性坏死不同病理时期的CT表现.结论:螺旋CT扫描能较早的发现股骨头缺血性坏死并能显示病变范围,在诊断股骨头缺血性坏死中具有重要价值.     

成人股骨头缺血性坏死累及髋臼的影像诊断

目的探讨成人股骨头缺血性坏死累及髋臼的CT及磁共振成像(MRI)的影像表现。方法对本院2014年5月至2015年12月共21例成人股骨头缺血性坏死累及髋臼的患者的CT及MRI的影像资料进行分析和研究。结果 21例患者均为股骨头缺血性坏死晚期患者(Ⅲ、Ⅳ期),其中14例为双侧股骨头缺血性坏死,7例为单侧股骨头缺血性坏死。12例股骨头缺血性坏死累及单侧髋臼,9例股骨头缺血性坏死累及双侧髋臼。结论 CT及MRI诊断成人股骨头缺血性坏死累及髋臼有十分重要的价值。     

股骨头坏死CT与MRI诊断的临床分析

目的:观察股骨头坏死CT与MRI征象,探讨其临床诊断价值。方法:回顾性分析我院2008年3月～2009年1月经临床病例证实的36例60个股骨头坏死的CT和MRI影像学资料,分析其诊断方法及临床价值。结果:Ⅰ～Ⅱ期共30个股骨头,CT检查16髋未见明显异常征象,14髋发现条带状和斑片状高密度硬化及局部囊变等征象。MRI检查均表现为不等的片状或线状高信号,并伴有少量关节腔内积液。Ⅲ期:17个股骨头,CT发现有16髋骨小梁缺失以及细小囊性变形成,而MRI发现17髋,表现为骨小梁缺失,部分呈长T1、T2信号。股骨头塌陷13例,CT发现12例,MRI发现13例。结论:MRI检查股骨头坏死,能提供其不同时期的影像特征,并可做出准确的判断,是临床检查股骨头坏死的一种较佳方法。     

成人股骨头缺血性坏死累及髋臼的CT、MRI表现

目的 :探讨成人股骨头缺血性坏死累及髋臼的CT及MRI表现。方法 :回顾性分析21例成人股骨头缺血性坏死累及髋臼患者的CT及MRI。结果:21例均为股骨头缺血性坏死晚期(Ⅲ、Ⅳ期),其中14例为双侧坏死,7例为单侧坏死。12例累及单侧髋臼,9例累及双侧髋臼。结论:CT及MRI诊断成人股骨头缺血性坏死累及髋臼有十分重要的价值。     

股骨头缺血性坏死CT分期诊断

目的　提高对股骨头缺血性坏死的分期认识。方法　对 5 6例经影像、临床确诊非外伤性股骨头缺血性坏死患者的首次 CT片进行分析。结果　 5 6例患者 ,70个股骨头中 , 期 1 3个 ,CT表现为“星征”变形 ,骨质斑片状硬化并疏松 ; 期 2 1个 ,CT表现为“星征”消失 ,骨质斑片状硬化和 (或 )囊状透光区 ; 期 2 0个 ,CT表现为骨质硬化、囊变 ,“新月”征阳性 ,骨质轻度碎裂 ,关节面轻度塌陷 ; 期 1 1个 ,CT表现为股骨头变形 ,骨质碎裂 ,关节面塌陷 ; 期 5个 ,CT表现为在 期基础上合并退性行骨关节病。结论　 CT能准确地对股骨头缺血性坏死进行分期 ,为临床选择治疗手段提供可靠依据     

股骨头无菌坏死弥散加权成像的临床应用

目的 对股骨头无菌性坏死(FHN)患者的磁共振弥散加权成像(DWI)的影像学特征进行总结分析,为FHN的诊断提供依据.方法 对22名股骨头正常者及42例FHN患者的磁共振信号分布及表观弥散系数(ADC)进行分析比较.结果 股骨头正常者T1加权像及T2加权像呈均匀高信号,DWI为低信号;FHN患者的T1加权像呈低信号和稍低信号,T2加权像呈不均匀高信号和稍高信号,DWI呈不均匀高信号.股骨头正常者、FHN患者病变周围区和中央区的ADC分别为(0.000～0.036)×10-3mm2/s、(0.111～0.311)×10-3mm2/s和(0.845-1.397)×10-3mm2/s,三者间的差异具有统计学意义(F=1384.28,P＜0.05).结论 FHN患者的DWI信号分布及ADC与股骨头正常者相比,具有明显的特异性,可用于对FHN患者的明确诊断,并可根据ADC的测量对骨髓病变进行量化分析.     

股骨头无菌坏死的MRI诊断

目的 研究MRI早期诊断股骨头无菌坏死（ANFH）的临床价值。方法 收集30例做过MRI、X线平片和CT检查的ANFH的临床资料进行分析和比较。结果 X线平片发现早期ANFH24个部位，其中I期9个，表现为骨质疏松及骨硬化；Ⅱ期15个部位，表现为骨硬化和囊状透亮区。CT表现早期病变19个，其中Ⅰ期11个，表现为星芒状结构变形骨疏松和骨硬化；Ⅱ期8个，表现为骨硬化和透亮区。MRI发现32个早期病变，其中Ⅰ期20个，表现为斑点状T1WI低信号或高信号；Ⅱ期12个，表现为T1WI不规则低等高信号。经统计学卡方检验，MRI和X线平片的检诊敏感性有显差异。结论 MRI可早期发现ANFH，敏感性和诊断价值明显优于X线平片和CT。     

MR imaging of femoral head avascular necrosis with STIR sequence

The uncomplicated bone necrosis is usually demarcated by reactive interface (RI). To analyze signal characteristics of RI, MR imaging of the hip was done using short TI IR (STIR) as well as short/long TR pulse sequences at 0.22 tesla. On STIR sequence the RI was observed as a high-signal line or ring with the shape identical to that of short TR image. The double line sign was not seen in early stage. The best explanation of high signal intensity of RI on STIR is that it has prolonged T1 and T2 secondary to high water content. It is concluded that STIR is an unique way to demonstrate RI in early osteonecrosis.     

Magnetic resonance imaging of avascular necrosis of the femoral head

This study investigates the role of magnetic resonance imaging (MR) in identifying avascular necrosis (AVN) of the femoral head and in monitoring its therapy. The detection of AVN, particularly in its early stages, is imperative to give therapeutic intervention the best opportunity for successful management. The results of magnetic resonance imaging are compared with those of the standard diagnostic modalities in evaluation of patients with the lesion. Examinations were performed at 0.12 T with a repetition time (TR) of 143 ms and times to echo (TE's) of 10 or 20 ms. This study represents a retrospective review of 90 hips which were examined in 45 consecutive patients. Of these, 52 hips were biopsied as part of treatment. MR was shown to be sensitive in the detection of AVN. Comparison of MR with radionuclide imaging showed comparable sensitivity and specificity. MR was also noted to be sensitive in the detection of early AVN. Preliminary results suggest that MR can monitor treatment of the affected hip, and may even be able to predict patient response to therapy. Although further work is necessary to determine the role of MR in the evaluation of the patient presenting with hip pain, MR is a sensitive method in detecting AVN and in monitoring its course in patients suspected of having the disease.     

Avascular necrosis of the femoral head: high-field-strength MR imaging with histologic correlation

Magnetic resonance (MR) images, contact radiographs, and histologic sections of six femoral head specimens with avascular necrosis were correlated. A low-signal-intensity band or ring represented the repair tissue interface surrounding a high-signal-intensity necrotic marrow segment. Large segmental areas of low signal intensity were observed on T1-weighted images when the lesion consisted of necrotic bone with amorphous marrow debris and adjacent thickened trabecular bone with mesenchymal repair tissue infiltration. On intermediate-weighted images, however, mesenchymal repair tissue, which was located inferior to the necrotic zone, increased markedly in signal intensity, permitting distinction from low-intensity necrotic bone with amorphous marrow debris. When trabecular thickening with collapse predominated, segmental areas of low signal intensity with both sequences were found. MR signal intensities used in combination with anatomic configuration and location may provide information of potential therapeutic importance regarding tissue composition and stage of disease.     

The role of MR imaging in avascular necrosis of the femoral head

Due to the pattern of its blood supply, the femoral head is particularly vulnerable to avascular necrosis (AVN). Nontraumatic AVN is a devastating disorder affecting young patients, and despite treatment it normally follows a progressive course toward a destructive osteoarthropathy. Magnetic resonance (MR) imaging is currently used in major classification systems solely for early detection of femoral head AVN when plain radiographs are normal. More recent data have shown that MR imaging may improve staging, investigate radiologically occult collapse, depict other causes of disability and pain, assess prognosis, and evaluate treatment. This article reviews the established and evolving role of MR imaging in patients at risk or with known femoral head AVN.     

多排螺旋CT与MRI检查股骨头坏死临床价值分析

目的探讨多排螺旋CT与MRI用于股骨头坏死诊断临床价值差异。方法对78例股骨头坏死患者的多排螺旋CT与MRI影像学检查资料,比较两种影像学方式股骨头坏死诊断阳性率,分期诊断情况及早期阳性征象检出率等。结果 MRI在股骨头坏死诊断阳性率和分期诊断情况方面均显著优于多排螺旋CT,差异有统计学意义(P0.05);MRI在股骨头坏死早期阳性征象检出率方面显著高于多排螺旋CT,差异有统计学意义(P0.05)。结论 MRI相较于多排螺旋CT具有更高软组织分辨率,可明确显示骨质坏死部位解剖形态。     

股骨头缺血坏死的分期与早期影像学诊断

目的 研究股骨头缺血坏死（ＡＮＦＨ）的分期、早期影像学表现及诊断价值。方法 ６２例双侧股骨头行Ｘ线、ＣＴ及低场ＭＲＩ检查,并对其影像学改变进行分期及等级稚和Ｈ检验和敏感性对照。结果 全部患者Ｘ线平片均诊断为早期ＡＮＦＨ,共９１个部位。其中Ⅰ期４６个,表现为骨疏松及骨硬化;Ⅱ期４５个,为骨硬化和囊状透亮区。ＣＴ发现５６例早期ＡＮＦＨ,共８６个部位。其中Ⅰ３４个,表现为星芒结构变形、骨疏松和骨硬化;Ⅱ     

股骨头缺血性坏死的基因治疗与影像学观察

股骨头缺血性坏死是骨科难治疾病之一,如早期得不到及时有效的治疗,可引起股骨头塌陷、变形,最终导致髋关节功能障碍.基因治疗是新近发展起来的一项新技术,随着分子生物学的发展和基因转移技术的成熟,治疗性血管生成为股骨头缺血性坏死的治疗提供了新的思路.综述股骨头缺血性坏死的基因治疗现状及影像学检查的作用.