多层螺旋CT及其后处理技术在股骨头缺血性坏死的诊断和分期的应用价值

目的:探讨多层螺旋CT及其后处理技术在股骨头缺血性坏死(ANFH)诊断和分期的应用价值。材料与方法:28例共36髋ANFH行多层螺旋CT扫描并进行多平面重建(MPR)、容积再现(VR)等后处理,分析其CT表现并进行分期。结果:根据CT表现诊断Ⅱ期12髋,Ⅲ期15髋,Ⅳ期9髋,CT表现主要为股骨头骨小梁增粗、变形,不规则形稍高密度区及边缘围绕硬化边,高密度灶与囊变区混合存在,软骨下骨折,股骨头塌陷,股骨头变扁及出现退行性骨关节病改变。结论:多层螺旋CT及其各种后处理技术能完整显示ANFH的各种征象,有助于准确分期,对临床治疗有重大的参考价值。

Diagnostic and Staging Value of Multi-slice Spiral CT and Post-processing Technique in Avascular Necrosis of the Femoral Head

Purpose： To investigate the CT findings and to evaluate the Value of multi-slice spiral CT（ MSCT） and post-processing technique in diagnosis and Staging of avascular necrosis of the femoral head（ ANFH）. Materials and Methods： MSCT was performed in 28 patients of ANFH. The raw data of all these cases were processed respectively by kinds of image reconstruction,including multiple planar reconstruction（ MPR） and volume rendering（ VR）. The staging of ANFH was performed based on the imaging findings. Results： According to the standards of Association Research Circulation Osseuse,there were 12 hips at stage Ⅱ,15 hips at stage Ⅲ and 9 hips at stage Ⅳ. The CT findings of 28 cases with ANFH were as follows： increased trabeculae and deformation of trabeculae,irregular mild high density area with sclerotic line or band around it;mixed high density area with cystiform change,subchondral fracture,joint surface subsidence,deformation of femoral head,femoral heads associated with secondary degenerative osteoarthropathy. Conclusion： MSCT and post-processing technique can clearly and completely show CT features of ANFH and play important roles in the accurate staging of ANFH. There is important reference value for clinical treatment.