股骨头缺血坏死CT诊断分析.docVIP

股骨头缺血坏死CT诊断分析[摘要] 目的：分析股骨头缺血坏死的CT影像表现，总结CT在早期股骨头缺血坏死中的诊断价值。方法：选取我院2008年3月~2009年6月收治并经过临床确诊为股骨头缺血性坏死的30例患者，回顾性分析其影像学表现。结果：30例患者均行X线和CT检查，X线检查确诊17例，确诊率为56.7%；CT检查确诊25例，确诊率为83.3%。两组确诊率比较差异有统计学意义（P0.05）。结论：CT能够早期显示股骨头缺血性坏死的病变形态，早期诊断效果优于常规X线检查，值得临床应用。 [关键词] CT 股骨头缺血坏死 影像分析 [中图分类号] R681.1[文献标识码]B[文章编号]1673-7210（2011）02（b）-166-02 Analysis on CT diagnosis of avascular necrosis of the fernoral head FU Zhishuang (Department of Radiology, the First People’s Hospital of Shenyang City, Liaoning Province, Shenyang 110041, China) [Abstract] Objective: To analyze the CT images of avascular necrosis of the fernoral head, and summary the value of CT in the early diagnosis. Methods: 30 patients with avascular necrosis of the fernoral head were collected in our hospital form March 2008 to June 2009, who were retrospectively analyzed with CT images. Results: 30 patients were given X-ray examination and CT examination, 17 cases in X-ray diagnosis, diagnosis rate was 56.7%, 25 cases in CT diagnosis, diagnosis rate was 83.3%. There were significant difference in two groups (P0.05). Conclusion: CT can show the early Lesion morphology of avascular necrosis of the fernoral head. Effect of early diagnosis of CT is better than conventional X-ray examination; it is worthy to extend in clinical application. [Key words] CT; Avascular necrosis of the fernoral head; Image analysis 股骨头缺血性坏死（avascular necrosis of the fernoral head，ANFH）是临床常见疾病，是由于各种不同的病因，破坏了股骨头的血供导致股骨头缺血、坏死、塌陷，多侵犯中年人，常导致严重髋关节功能障碍，是目前常见而又难治的疾病之一。早期诊断和治疗对患者的预后至关重要，目前影像学表现是临床选择治疗方法、判断病情和疗效的重要根据[1-2]。X线检查比较常用，但早期诊断不明确，以致延误治疗。CT可以发现股骨头缺血坏死的早期病变，对诊断治疗有重要作用，笔者收集30例股骨头缺血患者的影像表现，现分析报道如下： 1 资料与方法 1.1 一般资料 选取我院股骨头缺血性坏死30例患者，男21例，女9例；年龄22.0~65.0岁，平均40.6岁。按临床表现分：髋关节额疼痛9例，髋关节疼痛伴跛行与关节功能障碍18例，无明显临床表现3例。发病前髋关节外伤史10例，有长期服用激素类药物史8例，长期酗酒5例，原因不明7例。30例患者中，单侧髋关节受累18例，双侧髋关节受累12例，共42 侧关节受累。 1.2 方法 所有患者行X线骨盆正位平扫后，行双侧髋关节CT扫描，采用西门子欢悦双螺旋CT进行扫描，管电压110 kV，管电流120 mA，扫描层厚5 mm，FOV 360 cm2。 1.3 分期标准 1.3.1 X线分期参照1991年曹来宾[3]对股