CT versus MRI in diagnosis of early avascular necrosis of femoral head
-
摘要:目的 比较计算机断层扫描(CT)、磁共振成像(MRI)技术诊断早期股骨头缺血坏死的价值。方法 选取36例(47髋)股骨头缺血坏死患者, 均经手术病理检查确诊。所有患者均行CT、MRI检查。以手术结果为标准，判断CT、MRI诊断早期股骨头缺血坏死效果。结果 经手术病理证实，本组早期股骨头缺血坏死29例(38髋)。MRI对早期股骨头缺血坏死阳性检出率、敏感度、特异度分别为97.37%、97.30%、80.00%, 显著高于CT的78.95%、76.67%、11.76%(χ2=4.537、4.887、9.815, P=0.033、0.027、0.001)。结论 CT、MRI诊断早期股骨头缺血坏死各有利弊，而相较于CT, MRI阳性检出率更高，敏感度、特异度更高。Abstract:Objective To compare the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of early avascular necrosis of femoral head.Methods Totally 36 patients (47 hips) with avascular necrosis of femoral head were selected and diagnosed by surgical pathological examination. All the patients underwent CT and MRI examinations respectively, and the results of surgery were used as the standard to judge the efficacy of CT and MRI in the diagnosis of early avascular necrosis of femoral head.Results In this study, 29 patients with early avascular necrosis of femoral head (38 hips) were confirmed by surgical pathology. The positive detection rate, sensitivity and specificity of MRI for early avascular necrosis of femoral head were 97.37%, 97.30% and 80.00% respectively, which were higher than 78.95%, 76.67% and 11.76% of CT (χ2=4.537, 4.887, 9.815, P=0.033, 0.027, 0.001).Conclusion CT and MRI have their own advantages and disadvantages in the diagnosis of early avascular necrosis of femoral head. Compared with CT, MRI has higher positive detection rate, sensitivity and specificity.
-
-
表 1 CT、MRI对早期股骨头缺血坏死病变的阳性检出率比较[n(%)]
检查方法 0期 Ⅰ期 Ⅱ期 阳性率 手术病理 16(42.11) 15(39.47) 7(18.42) 38(100.00) CT 13(34.21) 12(31.58) 5(13.16) 30(78.57) MRI 16(42.11) 15(39.47) 6(15.79) 37(97.62)* 阳性检出率以髋数进行计算，共38髋。与CT比较, *P=0.033。 
下载: 导出CSV
表 2 CT、MRI对早期股骨头缺血坏死诊断效能分析
手术病理 CT MRI 合计 阳性 阴性 阳性 阴性 阳性 23 15 36 2 38 阴性 7 2 1 8 9 合计 30 17 37 10 47 阳性检出率以髋数进行计算，共38髋。
下载: 导出CSV
-
[1] 中华医学会骨科学分会关节外科学组. 股骨头坏死临床诊疗规范[J]. 中国矫形外科杂志, 2016, 24(1): 49-54. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHGJ201501029.htm [2] 王振涛, 郭跃, 谢斌, 等. 中老年股骨头坏死发病特点的研究[J]. 中国骨与关节损伤杂志, 2017, 32(8): 796-799. https://www.cnki.com.cn/Article/CJFDTOTAL-GGJS201708004.htm [3] 李莉莉, 钟佩茹. 非创伤性股骨头坏死发病相关因素及信号通路机制的研究进展[J]. 医学综述, 2018, 24(1): 22-27. doi: 10.3969/j.issn.1006-2084.2018.01.005 [4] Song H K, Choi H J, Yang K H. Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years[J]. Injury-international Journal of the Care of the Injured, 2016, 47(12): 2743-2748. doi: 10.1016/j.injury.2016.10.022
[5] Guerado E, Caso E. The physiopathology of avascular necrosis of the femoral head: an update[J]. Injury-international Journal of the Care of the Injured, 2016, 47(6): S16-S20. http://www.sciencedirect.com/science/article/pii/S002013831630835X
[6] 黄俊武, 叶菊花. 股骨头坏死的CT及X线表现及诊断价值分析[J]. 中国CT和MRI杂志, 2017, 15(2): 128-130. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201702040.htm [7] 顾苗苗, 张世昌. X线、CT和MR检查早期股骨头缺血坏死临床价值分析[J]. 医学影像学杂志, 2016, 26(11): 2137-2140. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ201611061.htm [8] 沈梓璇, 刘海龙, 肖梦强, 等. 股骨头缺血坏死的坏死指数与MRI分期的相关性分析[J]. 中国CT和MRI杂志, 2017, 15(1): 128-130. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201701041.htm [9] 中国医师协会骨科医师分会显微修复工作委员会. 成人股骨头坏死临床诊疗指南(2016)[J]. 中华骨科杂志, 2016, 36(15): 945-954. doi: 10.3760/cma.j.issn.0253-2352.2016.15.001 [10] 苏来提·肖合热提, 盛加根, 殷文靖, 等. 带血管腓骨移植治疗ARCOⅡ期与Ⅲ期股骨头坏死的步态功能分析[J]. 国际骨科学杂志, 2017, 38(3): 183-187. https://www.cnki.com.cn/Article/CJFDTOTAL-GWGK201703011.htm [11] Lampropoulou-Adamidou K, Hartofilakidis G. Avascular Necrosis of the Femoral Head[M]//Lampropoulou-Adamidou K, Hartofilakidis G. eds. Total Hip Replacement. Cham: Springer International Publishing, 2017: 83-92.
[12] 魏戎, 武军龙, 崔国峰. 成人股骨头缺血性坏死的影像学诊断与临床应用[J]. 医学综述, 2017, 23(12): 2438-2442. doi: 10.3969/j.issn.1006-2084.2017.12.031 [13] 赵谦成. 不同影像技术对股骨头缺血性坏死的早期诊断价值[J]. 中国药物与临床, 2016, 16(1): 42-43. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201601017.htm [14] 任勇, 母其文, 陈世孝, 等. DR技术与CT技术在股骨头缺血性坏死中的诊断价值[J]. 医学临床研究, 2016, 33(11): 2240-2242. [15] 唐贤钧. 股骨头缺血性坏死患者采用MRI、螺旋CT以及DR三种检测方式对其分期诊断效果的对比分析[J]. 中国CT和MRI杂志, 2016, 14(12): 130-132. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201612043.htm [16] 邓祥春. DR、CT、MRI在股骨头缺血性坏死分期中价值的临床对比研究[J]. 临床和实验医学杂志, 2016, 15(3): 281-284. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLC201603031.htm [17] 唐贤钧. 股骨头缺血性坏死患者采用MRI、螺旋CT以及DR三种检测方式对其分期诊断效果的对比分析[J]. 中国CT和MRI杂志, 2016(12): 130-132. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201612043.htm [18] 沈梓璇, 刘海龙, 肖梦强, 等. 股骨头缺血坏死的坏死指数与MRI分期的相关性分析[J]. 中国CT和MRI杂志, 2017, 15(1): 128-130. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201701041.htm
计量
- 文章访问数: 452
- HTML全文浏览量: 300
- PDF下载量: 23
苏公网安备 32100302010246号
