股骨颈疝窝的影像学表现及临床价值研究

目的：探讨股骨颈疝窝的影像学表现及临床价值。方法：回顾性分析1例经手术病理证实及20例符合Pitt等描述典型影像学征像的股骨颈疝窝患者的影像学表现，男17例，女4例；年龄30-85岁，平均53岁。所有病例均行X线和CT检查，其中13例行MRI检查。结果：21例发现股骨颈疝窝病灶29个，累及右侧9例，左侧8例，双侧4例，病灶均位于股骨头基底部或股骨颈前外侧皮质下，病灶多呈圆形或卵圆形，最大直径约16mm，X线表现为透亮区或硬化环，CT表现为骨质缺损区，密度因成分不同而呈软组织密度、脂肪密度或混杂密度，边缘伴有薄层清晰硬化缘，临近骨皮质见局限性裂隙样缺损与骨质缺损灶相通，MRI信号不定，多数表现为T1WI呈低信号，T2WI呈高信号。结论：股骨颈疝窝的影像学表现较有特异性，CT检查对诊断及鉴别诊断有重要意义，基本可以确诊，X线及MRI检查具有辅助诊断作用。

Imaging manifestation and clinical value in herniation pit of femoral neck

Objective: To discuss the imaging manifestation and clinical value in herniation pit of femoral neck. Methods: One case proved by operation and pathology and twenty cases with typical imaging manifestation described by Pitt were reviewed retrospectively. There were 17 males and 4 females with an average age of 53 years old(ranging from 30 to 85 years). All cases were examined by X-ray films and CT,and 13 cases were performed with MRI.Results: Twenty-nine lesions were found in the 21 cases,9 cases were in right side,8 cases were in left side,4 cases were in both sides. The lesions were all located in the superior lateral part of the femoral neck and anterior lateral base of femoral head. The lesions were round or oval,and most of their greatest diameter was less than 16 mm. X-ray films showed a central radiolucency with a thin clear sclerotic rim or simple sclerotic loop. CT scans showed a well-defined lesion of soft-tissue attenuation with sclerotic margin. The lesions had focal cortical perforation. On MRI images,most lesions showed uniformly long T1 and long T2 fluid signal intensity. Conclusion: Herniation pit of femoral neck have some specific imaging features,CT can make accurate diagnosis. X-ray and MRI are helpful to diagnosis.