MRI对股骨颈骨折术后并发股骨头坏死早期诊断临床研究.docVIP

MRI对股骨颈骨折术后并发股骨头坏死早期诊断临床研究 　　[摘要] 目的 探讨MRI对股骨颈骨折术后并发股骨头坏死早期诊断的影响。 方法 随机选取2011年5月～2012年12月我院股骨颈骨折术后并发股骨头坏死患者65例，对所有患者皆进行MRI及 X线片影像学检查。分析不同时期的诊断敏感性，并对其股骨头坏死进展情况进行比较。 结果 MRI检查在3个月内敏感性为20.00%，4～6个月敏感性为24.62%，7～9个月敏感性为32.31%，10～12个月为26.15%，均显著高于X线片检查结果（7.69%、9.23%、20.00%、7.69%），两组比较，差异有统计学意义（P0.05）。MRI随时间变化的股骨头坏死进展，放射前期到骨关节炎期所需发现时间随疾病的进展而增加，差异有统计学意义（P0.05）。 结论 股骨颈骨折术后3个月即可接受常规MRI检查，预防股骨头坏死的发生，适合于临床推广应用。 　　[关键词] MRI；股骨颈骨折；股骨头坏死；早期诊断 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-4721（2015）06（c）-0053-03 　　[Abstract] Objective To explore the effect of MRI in the early diagnosis of transcervical fracture postoperative osteonecrosis of the femeral head. Methods 65 cases of transcervical fracture postoperative osteonecrosis of the femeral head in our hospital from May 2011 to December 2012 were randomly selected，and all patients were performed MRI and X-ray imaging.The different periods of sensitivity and progress of osteonecrosis of the femeral head along with the time change were all observed and compared. Results The sensitivity of MRI examination in 3 months，4-6 months，7-9 months，10-12 months was 20.00%，24.62%，32.31%，26.15%，which were significantly higher than those for X-ray examination results（7.69%，9.23%，20.00%，7.69%），the differences were statistically significant between the two groups （P0.05）.In the progress of ONFH along with the time change in MRI，the desired discovery time from radiation pre to osteoarthritis increased with the progression of the disease，the difference was statistically significant （P0.05）. Conclusion The routine MRI examination can be implemented in 3 months after the operation of transcervical fracture，to exclude the possibility of complicated with osteonecrosis of the femeral head. 　　[Key words] MRI；Transcervical fracture；Osteonecrosis of the femeral head；Early diagnosis 　　股骨颈骨折是骨科临床的常见骨折类型。随着手术方式及内固定材料的不断发展，股骨颈骨折患者发生术后骨不连现象的概率有显著下降，但术后出现股骨头坏死等并发症的概率却未见相应减少[1-2]。因此对股骨颈骨折术后并发股骨头坏死的早期诊断显得尤为重要。本文随机选取2011年5月～2012年12月我院股骨颈骨折术后并发股骨头坏死患者65例，探讨MRI对股骨颈骨折术