成人股骨头缺血坏死的影像学探讨

目的对比成人股骨头缺血坏死的X线、CT、MR影像表现，探讨其早期影像诊断方法。方法回顾分析30例股骨头缺血坏死病人影像资料，进行总结比较。其中13例X线平片检查，19例CT检查，13例MRI检查。结果30例中双侧发病24例，单侧发病6例。X线表现：13例中阳性表现7例（阳性率54％），均有不同程度骨质硬化及囊变，股骨头碎裂变形5例，关节半脱位3例。CT表现：19例中14例坏死征象明显（阳性率74％），不同程度的表现为“地图征”、囊性变、碎裂，关节半脱位3例，关节囊积液8例。MR表现：13例均有阳性表现（阳性率100％），关节囊不同程度积液9例，“双线征”5例。绪论MRI对股骨头缺血坏死的早期诊断较X线平片和CT敏感，是理想的检查方法。

Imaging discussion on avascular necrosis of femoral head in adult

Objective To study a better early diagnosis imaging method about adult avascular necrosis by X-ray,CT and MRI. Methods 30patients imaging data with avascular necrosis were selected to compare. 13cases were detected by X-ray,19 patients by CT and 13 cases by MRI. Results The imaging data showed：24 cases in 30 cases necrosised in both sides and the rest were unilateral incidence. X-ray sbowed：7 cases were positive in 13 cases with different degree bone sclerosis and cystic degeneration,5 cases were observed femoral head fracture deformation. Joint subluxation were observed in 3 cases. CT sbowed：14 cases in 19 cases had obvious necrosis with different degree of performance ＂Levy map＂, cystic change and fragmentation; Joint subluxation were observed in 3 cases; the joint capsule effusion were observed in 8 cases. Finally we analysised the imaging data from MRI：13 patients had significant positive and the joint capsule with different degree effusion were observed in 9 cases; ＂Lane sign＂ were 5cases. Conclusion It is suggested that MRI is more sensitive than Xray and CT in the early diagnosis of avascular necrosis and may be an ideal method.