早期成人股骨头缺血坏死核素扫描和MRI对比研究_医学论文.docVIP

早期成人股骨头缺血坏死核素扫描和MRI对比研究_医学论文 早期成人股骨头缺血坏死核素扫描和MRI对比研究_医学论文 作者：刘吉华 张淑萍 王绍华 左书耀 【关键词】 股骨头坏死放射性核素显像磁共振成像 　　［摘要］目的 探讨早期成人股骨头缺血坏死（FHN）核素扫描和MRI征象之间的对应关系及其诊断的灵敏度。方法 分析比较48例72髋经随访和病理证实或具有典型X线和CT表现的早期（FICAT Ⅰ～Ⅱ期）成年FHN病人的髋关节核素扫描和MRI资料。全部病例核素扫描和MRI检查均于5 d内完成。结果 核素扫描示股骨头局限性稀疏3髋，MRI上“线样征”远侧区均呈正常骨髓信号核素扫描示典型或不典型“炸面圈征”35髋，弧形或环形浓集区对应MRI上“线样征”及其远侧的异常信号区核素扫描示股骨头上方轻度浓集、基底部和（或）颈部条带状明显浓集8髋，条带状明显浓集区对应MRI“线样征”及其远侧的异常信号区，轻度浓集区对应“线样征”包绕的异常信号区核素扫描示局限性浓集6髋，MRI上“线样征”包绕区均较小核素扫描示股骨头或头颈部弥漫性浓集17髋，MRI上15髋显示“线样征”，12髋“线样征”远侧区信号异常，2髋弥漫性长T1 长T2 信号，无“线样征”核素扫描示3髋正常，MRI示“线样征”远侧区均正常。核素扫描和MRI诊断灵敏度分别为95.83%和100.00%，两者比较无显著性差别（ P =0.122）。结论 早期成人FHN不同核素扫描表现类型与MRI示“线样征”及其包绕区大小信号和远侧区表现有一定的对应关系。核素扫描诊断灵敏度与MRI相当。 　　［关键词］ 股骨头坏死放射性核素显像磁共振成像 　　 　　［ABSTRACT］ObjectiveTo investigate the correlation of radionuclide bone scanning and MRI in the early stage of femoral head necrosis （FHN） in adults. MethodsData of 72 hips from 48 adults with early FHN （FICAT stage Ⅰ-Ⅱ） confirmed by follow-up or pathology or typical X-ray and CT were analyzed. The radionuclide scanning and MRI were all completed within five days. ResultsThree hips showed localized osteoporosis in femoral head on radionuclide bone scan， while on MRI， the signals in distal area of “line-like sign” showed normal35 hips showed atypical or typical bread-fried ring sign on radionuclide bone scan， which correlated to MRI “line-like sign”eight hips showed slightly increased uptake in the superior end of femoral head and band-like region of obviously increased uptake in inferior end of femoral head and/or femoral neck，the former corresponded to the area surrounded by “line-like sign” on MRI， and the latter to “line-like sign” as well as the outer nearby areasix hips showed localized uptake increased which corresponded to smaller area surrounded by “line-like sign” on MRI17 hips showed diffuse uptake in the head on radionuclide bone scan，in which， 12 showed abnormal signal beneath “line-like sign” near femoral neck， and two showed diffuse abnormal signal of femoral head