股骨头坏死MRI信号表现和瘀积程度对临床疗效的影响

目的:基于MRI对组织特性的良好识别性,研究观察股骨头坏死的MRI信号不同表现对疗效的影响,为临床诊治提供更多参考依据。方法:回顾54例(85髋)均保髋治疗的股骨头坏死病例。术前X片评估:按ARCO分期方法进行分期I、II、III、IV期。术前MRI评估:(1)股骨头内信号的病理分期;(2)将股骨头骨髓水肿评分和关节积液评分相加记为关节的瘀积指数。评估术后随访X片以观察疗效。结果:MRI反映的病理分期中,处于中期的治疗结果差,且差异有统计学意义(P0.05);而MRI病理分期的中期病例行不同手术治疗结果比较,差异没有统计学意义(P0.05)。MRI反映的患髋瘀滞程度重者结果差,差异有统计学意义(P0.05)。结论:研究结果显示用MRI信号表现判断股骨头坏死治疗的预后是有一定价值的,并且对于进一步中医辨证论治提供了一定客观化指标。

Effect of MRI and Stasis Degree on Clinical Result of Femoral Head Osteonecrosis

Objective:This study is to find more information by MRI for clinical decision.Methods:54 cases(85 hips)with preserving femoral head therapy were retrospectively reviewed.Before operation,cases were classified by X-ray representation based on ARCO classification.MRI representations including four stages of pathologic classification based on MRI signal character and bone marrow edema(BME)score and joint effusion score which were used as stasis index were evaluated.Evaluate effects by reviewing follow-up X-rays.Result:This study showed cases in middle stage on MRI had worst effect,which had significant difference(P<0.05).Furthermore,there was no significant difference between the groups with different preserving operations in middle stage of MRI signal character.Conclusion:This study suggests that MRI can show the progress of repair,which is connected with the prognosis.BME and effusion on MRI are some kinds of reference for Traditional Chinese Medicine treatment based on stasis theory.