成人股骨头缺血坏死全髋关节置换手术前后的影像学评价

目的：加深和提高对股骨头缺血坏死影像学诊断的认识,并对人工全髋关节置换术前、术后的影像学价值进行评估。方法：回顾性分析58例作全髋关节置换术患者的术前股骨头缺血坏死的X线（DR）、CT和MRI影像学改变特征,并对人工全髋关节置换术后X线（DR）片进行评估。结果：58例患者,术前采用X线、CT及MRI诊断股骨头缺血坏死累计80个股骨头。其中64个股骨头行人工全髋置换（6名患者为双侧）,12个股骨头行钻孔减压植骨术,4个股骨头为非手术治疗。行人工全髋关节置换64个中,术后证实股骨头缺血坏死42个,髋关节发育不良继发骨关节病20个,创伤性骨关节炎2个。结论：股骨头缺血坏死中晚期患者,X线（DR）检查简便易行,结合CT、MRI检查,诊断准确率很高;人工全髋置换术是目前治疗晚期股骨头缺血坏死的最好选择。

The Evaluation of the Imaging Methods for Adult Total Hip Replacement for Avascular Necrosis of the Femoral Head

Objective： To strength and improve the understanding of imaging diagnosis and evaluate the value of imaging before and after total hip replacement. Methods： retrospective analysis of the X ray, CT and MRI imaging characteristics for 58 cases of avascular necrosis of the femoral head before total hip replacement treatment and evaluated X ray （DR） after total hip replacement. Results： Using X ray, CT and MRI imaging, 58 patients were diagnosis as avascular necrosis of the femoral head before operation, with total of 80 femoral heads, among which 64 cases were treated with artificial total hip replacement （6 cases were affiliated by both sides）, 12 cases were treated by drilling decompression combined with bone grafting, 4 cases were non-surgery treatment. Among 64 cases with artifical total hip replacement, 42 cases were confirmed as avaseular necrosis of the femoral head. 20 cases with developmental dysplasia of the hip, together with osteoarthrosis; 2 cases were confirmed as traumatic osteoarthritis. Conclusion： During the middle and latter stage of avascular necrosis of the femoral head. X Ray is a simple and economic method. Combined with CT and MRI, it has a high accuracy rate of diagnosis. Total hip replacement represents until now the best choice for latter stage of avascular necrosis of the femoral head.