髋关节病变的CT影像分析

目的 阐明髋关节病变的CT表现,评价CT在诊断髋关节病变中的价值.方法 回顾分析经临床确诊或病理证实的126例髋关节病变的CT征象,其中股骨头缺血性坏死32例,退行性骨关节病24例,强直性脊柱炎伴髋关节改变8例,髋关节炎性改变(包括结核)19例,转移瘤17例,髋臼或股骨头、颈部骨折26例.对126例患者采用双侧髋关节对照常规位CT扫描,层厚5 mm,间距5 mm.结果 股骨头缺血坏死显示股骨头硬化、囊变及软骨下骨折,晚期继发骨性关节炎改变;退行性骨关节病以承重区关节畸形和骨性关节面改变为主,软骨下囊变特别明显;强直性脊柱炎累及髋关节表现为髋臼关节面锯齿状或毛刷状破坏;髋关节结核关节面广泛骨质破坏,可见到小死骨和寒性脓疡;类风湿性关节炎关节间隙普遍狭窄,关节面下小囊肿周围无明显骨硬化;滑膜骨软骨瘤病显示滑膜增厚和其内小钙化灶,较大的骨软骨体呈桑椹状表现.结论 各种髋关节病变的CT表现不同,CT能清楚显示髋关节解剖结构及病变的部位、范围和病理解剖细节,在鉴别诊断、了解病情的发展和疗效观察方面有很大优越性.

The evaluation analysis of CT images in diagnosis of hip lesions

Objective To illustrate with CT manifestations,diagnosis hip lesions in the evaluation of CT of the value of clinical diagnosis. Methods Retrospective analysis of 126 cases of pathologically proven or CT signs with avascular necrosis, 32 cases, degenerative osteoarthritis (oa) was 24 patients with ankylosing spondylitis, hip changes in 8 cases, hip inflammatory change( including 19 cases were tuberculosis), 17 cases of metastases ,femoral neck hip fracture, or 26 patients. 126 patients using conventional bilateral hip contrast CT scan, a thick layer of 5 mm,spacing 5 mm. Results The necrotic showed the femoral hardening, capsule became subchondral fractures, and advanced osteoarthritis secondary changeed; Degenerative joint disease to bearing zone joint deformities and joint osteoarthritis,cystic changed subchondral particularly variable;Ankylosing spondylitis involving the hip joint performed for the acetabular serrate or brush shape;Hip joint tuberculosis was widely bone destruction, small dead bone and cold sex abscess;In rheumatoid arthritis,joint space was commonly narrow and under the face there was no obvious bone cyst hardening;Around synovial osteochondromatosis tumour disease showed synovial thickening and overses microcalcifications, bone and cartilage the mulberry. Conclusion CT can clearly show the pathological anatomy and hip, scope and anatomic details in the differential diagnosis of disease development,and has great advantages in clinical observation.