MRI评价早期激素性股骨头坏死患者的微循环变化研究
MRI Evaluation of Microcirculation Changes in Patients with Early Hormone-Induced Femoral Head Necrosis
耿加宏 1周超 1伍晗1
作者信息
- 1. 江苏省金湖县中医院放射科,江苏 淮安 211600
- 折叠
摘要
目的:探讨核磁共振成像(MRI)评价早期激素性股骨头坏死(SNFH)患者的微循环变化价值.方法:本研究选取 2019年 2月—2022年 12月本院诊治的 76例疑似早期激素性股骨头坏死患者为研究对象,所有患者均给予MRI检查,记录成像特征与微循环变化情况,判断诊断价值.结果:在 76例患者中,病理诊断为早期激素性股骨头坏死26例(股骨头坏死组)与髋关节骨性关节炎50例(骨关节炎组).股骨头坏死组的MRI的骨小梁模糊、骨髓水肿、局部囊变、线样征等占比分别为 80.8%、84.6%、92.3%、80.8%,均高于骨关节炎组的 12.0%、16.0%、50.0%、20.0%,组间差异有统计学意义(P<0.05).股骨头坏死组的核磁共振微循环脂肪分数、灌注分数均高于骨关节炎组,组间差异有统计学意义(P<0.05).MRI判断为早期激素性股骨头坏死 25例,MRI鉴别诊断早期激素性股骨头坏死患者的敏感性与特异性分别为 96.2%、100.0%,受试者工作特征(ROC)曲线分析显示MRI鉴别诊断早期激素性股骨头坏死患者的最大曲线下面积为 0.877.结论:早期激素性股骨头坏死患者在MRI上多表现为骨小梁模糊、骨髓水肿、局部囊变、线样征,伴随有微循环脂肪分数、灌注分数增加,MRI诊断早期激素性股骨头坏死患者具有很高的敏感性与特异性.
Abstract
Objective:To explore the value of magnetic resonance imaging(MRI)in the evaluation of microcirculation changes in patients with early steroid-induced osteonecrosis of the femoral head(SNFH).Methods:In this study,76 patients with suspected early steroid-induced osteonecrosis of the femoral head diagnosed and treated in our hospital from February 2019 to December 2022 were selected as the research objects.All patients were given magnetic resonance imaging examination,and the imaging characteristics and microcirculation changes were recorded to determine the diagnostic value.Results:Among the 76 patients,26 patients were pathologically diagnosed as early steroid-induced osteonecrosis of the femoral head(ONFH group)and 50 patients were pathologically diagnosed as hip osteoarthritis(OA group).The proportions of bone trabeculae blur,bone marrow edema,local cystic degeneration,and linear sign in the femoral head necrosis group were 80.8%,84.6%,92.3%,and 80.8%,respectively,which were higher than 12.0%,16.0%,50.0%,and 20.0%in the osteoarthritis group respectively,and the differences between the groups were statistically significant(P<0.05).The MRI microcirculation fat fraction and perfusion fraction in the osteonecrosis group were higher than those in the osteoarthritis group,and the difference between the groups was statistically significant(P<0.05).Twenty-five cases were diagnosed as early steroid-induced osteonecrosis of the femoral head by magnetic resonance imaging.The sensitivity and specificity of MRI in the differential diagnosis of early steroid-induced osteonecrosis of the femoral head were 96.2%and 100.0%,respectively.Receiver operating characteristic(ROC)curve analysis showed that the maximum area under the curve of MRI in the differential diagnosis of early steroid-induced osteonecrosis of the femoral head was 0.877.Conclusion:Patients with early steroid-induced osteonecrosis of the femoral head on MRI mostly show bone trabecula blur,bone marrow edema,local cystic degeneration,linear sign,accompanied by the increase of microcirculation fat fraction and perfusion fraction.Mri has high sensitivity and specificity in the diagnosis of early steroid-induced osteonecrosis of the femoral head.
关键词
早期激素性股骨头坏死/MRI/骨髓水肿/微循环/脂肪分数/灌注分数Key words
Early steroid-induced osteonecrosis of the femoral head/Magnetic resonance imaging/Bone marrow edema/Microcirculation/Fat fraction/Fraction of perfusion引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据