SARS患者缺血性骨坏死的MR初步研究

目的研究严重急性呼吸综合征(SARS)患者缺血性骨坏死的MR诊断,并研究激素使用与缺血性骨坏死的关系.方法 65名在2003年3月-2003年5月间患SARS的患者,住院期间均使用不同剂量及不同时间的激素,在住院期间及出院后均出现不同程度的关节疼痛.康复1～3个月后分别进行平片,CT和MR检查,记录有无异常、病变的部位,以及激素的使用方法和剂量.结果共有28名患者出现不同部位的骨坏死,其中:3名患者为双侧股骨头缺血性坏死,4名为单侧股骨头缺血性坏死,5名为双侧股骨头、股骨远端和/或胫骨近端缺血性骨坏死,4名为单侧股骨头、股骨远端和/或胫骨近端缺血性骨坏死,10名患者为股骨远端和胫骨近端缺血性骨坏死,1名患者为右侧腓骨近端,1名患者为股骨远端,胫骨近端和左侧距骨缺血性骨坏死.这些患者的平片或CT检查结果均为阴性.尽管出现缺血性骨坏死的患者激素使用量高于未出现缺血性者,但二者差异没有显著性(P=0.12).结论 SARS患者可以出现缺血性骨坏死,而激素的使用可能是导致缺血性骨坏死的主要原因.

Avascular necrosis of bone in SARS patients: initial

Objective To report the incidence of avascular necrosis (AVN) in severe acute respiratory syndrome (SARS) patients,and to study the relationship between the use of steroids and the development of AVN. Methods Sixty-five SARS patients who had large joint pain between March 2003 and May 2003 underwent plain radiographs,CT and MRI examination 1-3 months after their recovery from the illness. All these patients received steroids treatment. All plain film,CT and MR images were analyzed by two experienced radiologists. Any abnormalities,location,extent,morphology,the number,size and signal intensity of lesions were evaluated. Results Twenty-eight patients were identified with AVN. Three patients had bilateral AVN of the hips,4 patients of one femoral head,5 patients of the bilateral hips,distal femur and proximal tibia,4 patients of the ipsilateral hip and knees,10 patients of knees,one patient of right proximal fibula,and one patient of knees and talus. Results of hip,knee and ankle plain radiographs were negative. There was no trend of increasing risk for AVN associated with the amount of steroids ( P =0.12). Conclusion AVN could occur in the patients with SARS. AVN had a strong association with the duration of steroid use.