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。

Comprehensive imaging diagnosis on the early avascular necrosis of femoral head in adult

Objective: To investigate the corresponding manifestations of MRI,CT,SPECT and DR in the early femoral head necrosis(FHN)in adult and to explore their sensitivity,thus to establish an imaging standard in early diagnosis of FHN.Methods: Twenty-two cases(30 hips) with early FHN in adult(ARCOⅠ-Ⅱ) proved by follow-up study,or typical imaging manifestations were analyzed.All patients underwent MRI,CT,SPECT and DR in the same period.Results: "Line-like sign"appeared on MRI in 30 of all affected hips,including single(15) and double lines(15).They corresponded to the blurred high-density sclerosis line(14)on CT,two parallel lines consisting of a low density inner lines adjacent to a high-density line(7),high-density sclerosis spots(5);roud or arc-like band of increased uptake of radioisotope on SPECT in 23 hips;band-like sclerosis on DR film in 13 hips.Conclusion: "line-like sign"on MRI corresponds to the high-density sclerosis line around weight-supporting zone on CT,round or arc-like band of increased uptake of radioisotope in femoral neck or inferior part of femoral head on SPECT,and band-like burred sclerosis on DR.These manifestations are their specific signs in diagnosing early FHN,and MRI is superior to CT,SPECT and DR.