低场强磁共振成像在股骨头坏死诊断中应用.doc

低场强磁共振成像在股骨头坏死诊断中应用[摘要] 目的 探讨股骨头坏死的低场强磁共振诊断。方法 对18例共26个经磁共振诊断为股骨头缺血坏死的MRI图像进行观察和分析,并对其影像学改变进行分期。结果 26个股骨头中,0期3个,Ⅰ期5个,Ⅱ期5个,Ⅲ～Ⅳ期13个,低场MRI能较特异地反映股骨头缺血坏死的各期表现,“双线征”是股骨头缺血坏死早期的特征表现。结论 低场MRI不仅能发现股骨头缺血坏死的早期病变,而且能反映病变的确切范围和程度,对早期治疗和预后都有积极意义。 [关键词] 低场强磁共振; 影像; 股骨头坏死; 诊断 [中图分类号] R681.8 [文献标识码] A [文章编号] 1673-9701(2010)01-57-02 Application of Low-field Magnetic Resonance Imaging in the Diagnosis of Femoral Head Necrosis QIAN Jiaxin Department of Imaging,Yangzhong Municipal PeoplesHospital,Yangzhong 212200,China [Abstract] ObjectiveTo evaluate the diagnosis value of low-field magnetic resonance imaging(MRI) in femoral head necrosis. Methods Twenty-six femoral heads of 18 cases of femoral head necrosis were studied with MRI,and their image changes were staged. ResultsTwenty-six femoral heads showed Stage zero for 3 heads,Stage I for 5,Stage II for 5 and Stages III～ IV for 13. Low-field MRI could specifically reflect each stage of imaging findings of femoral head necrosis. “Double-line sign” was the characteristic expression of MRI in early femoral head necrosis. ConclusionLow- field MRI can exactly display early femoral head necrosis and reflect accurate the scope and the degree of the lesion. It is of great value in its early treatment and prognosis. [Key words]Low-field magnetic resonance imaging; Imaging; Femoral head necrosis; Diagnosis 股骨头缺血坏死(avascular necrosis of femoral head,ANFH)是临床常见的病症,因股骨头缺血导致骨坏死,影响局部或整个髋关节,引起软骨坏死,股骨头塌陷、变形,关节功能丧失。早期诊断及准确分期对于临床制定正确的治疗方案,保留关节功能,改善预后起着决定性作用。MRI对ANFH的诊断准确性及早期ANFH的敏感性已为共识,是目前最主要的诊断方法之一。本文总结2007年1月～2009年6月间经临床诊断为股骨头坏死的18例26个股骨头的低场MRI表现,并予以分析。 1 资料与方法 1.1 一般资料 18例患者中男12例,女6例。年龄21～69岁,平均42岁。其中双侧股骨头病变8例,单侧病变10例,共26个股骨头。18例中有外伤史8例,有服用皮质醇史者5例,无明确诱因者5例。临床表现为关节疼痛及功能障碍,一般呈钝痛,有时疼痛向股部、臀部、膝内侧放射。疼痛以夜间、活动时加重,休息后减轻,晚期出现跛行。 1.2 检查方法 18例患者均经MRI检查,采用国产鑫高益公司生产的0.35T开放式永磁型磁共振扫描机。患者取仰卧位,选用体线圈,各序列行轴位、冠状位成像。SE序列T1加权像,TR350～420ms,TE18～20ms,FSE序列T2加权像,TR3000～3500ms,TE90～105ms,IRFSE序列T2加权像,TR3000～3500ms,TE100～120ms,TI70～90ms平均