暂时性骨质疏松症的MRI表现

目的:探讨暂时性骨质疏松症的MRI表现。方法:对经临床证实的10例暂时性骨质疏松症(TOH)患者的临床及影像学资料进行回顾性分析。10例患者均行MRI平扫,其中5例行MRI增强扫描,4例行CT扫描。10例中男7例,女3例,年龄为25～40岁。结果:10例TOH中,双侧髋关节同时受累2例,单侧受累8例,主要MRI表现为弥漫性骨髓水肿,累及股骨头、颈及转子间,股骨头形态完整,1例可见软骨下应力性骨折,所有病例均无股骨头软骨下骨质缺损;关节囊肿胀和关节积液8髋;MRI增强扫描示病变区呈明显均匀强化。主要CT表现为股骨头骨密度弥漫性减低,骨皮质变薄。治疗5～11个月后患者疼痛症状消失,股骨内MRI信号恢复正常。结论:CT上表现为弥漫性骨质疏松、MRI表现为弥漫性骨髓水肿、缺乏软骨下骨质病变以及均匀一致强化是TOH性特征的影像学表现。

MRI findings in transient osteoporosis of the hip

Objective：To study the MRI findings in transient osteoporosis of the hip（TOH）.Methods：MR and CT images of TOH in 10 patients were retrospectively analyzed.MRI examinations were performed in all patients;in addition,contrast enhancement MR examinations were performed in 5 patients and CT examinations in 4 patients.Of the 10 patients,7 were male and 3 were female,with the age ranging from 25~40 years.Results：The bilateral hips were affected in 2 patients and the single hip was affected in 8 patients.The MR images demonstrated diffuse bone marrow edema involving the femoral head,neck and the inter-trochanteric region.The osseous epiphyseal contour remained intact,subchondral fracture was seen in one patient and none of the patients had subchondral lesions.The joint capsule edema and joint effusion were noted in 8 hips.Contrast-enhanced MRI demonstrated enhancement of marrow edema in 5 patients.CT scanning demonstrated diffuse osteopenia in the trabecular bone and a thinned cortex.After treatment for 5 to 11 months the symptoms of the patients with TOH disappeared and MR images were normal.Conclusion：The diffuse osteopenia on CT and diffuse bone marrow edema,absence of subchondral lesions and enhancement of marrow edema on MRI are the imaging features of TOH.