中国CT和MRI杂志2024,Vol.22Issue(4) :151-153.DOI:10.3969/j.issn.1672-5131.2024.04.046

股骨头坏死ARCO 3A期平片分期准确性及误分期原因分析

Analysis of Accuracy and Reasons for Misstaging of ARCO 3A of Femoral Head Necrosis by Radiography

史珊 佟海滨 杨学东 范洋洋 刘欢 张阔 马云瑶 于潼
中国CT和MRI杂志2024,Vol.22Issue(4) :151-153.DOI:10.3969/j.issn.1672-5131.2024.04.046

股骨头坏死ARCO 3A期平片分期准确性及误分期原因分析

Analysis of Accuracy and Reasons for Misstaging of ARCO 3A of Femoral Head Necrosis by Radiography

史珊 1佟海滨 1杨学东 1范洋洋 1刘欢 1张阔 2马云瑶 1于潼3
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作者信息

  • 1. 中国中医科学院广安门医院放射科(北京 100053)
  • 2. 北京大学第一医院门诊部(北京 102627)
  • 3. 中国中医科学院广安门医院骨科(北京 100053)
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摘要

目的 评估X线平片对股骨头坏死ARCO3A期分期的准确性,并分析其误分期的原因.方法 回顾性分析2017年1月至2023年7月同期行髋关节正、蛙式位X线及CT检查,且髋关节CT分期为ARCO3A期的158例股骨头坏死患者,其中14例为双侧ARCO3A期,共计172例ARCO3A期股骨头坏死,F/M=67/91,平均年龄43.7±11.8岁.观察髋关节X线正、蛙式位图像进行ARCO分期并统计结果.结果 髋关节X线分期为ARCO 3A期139例,误分期为ARCO 2期33例,准确率为80.8%;对照同期髋关节CT图像,X线误分期病例中未发现软骨下骨折6例(18.2%)、未发现坏死区骨折4例(12.1%)、未发现股骨头局限塌陷23例(69.7%).结论 X线对股骨头坏死ARCO 3A期分期的准确性高,但仍存在误分期的状况.在临床工作中,正位结合蛙式位,仔细观察关节面局部轻微不光整及软骨下、坏死区骨折等征象有助于提高X线平片对股骨头坏死ARCO3A期分期的准确性.

Abstract

Objective To evaluate the accuracy of radiography for ARCO stage 3A of femoral head necrosis(FHN)and to analyze the reasons for its misstaging.Methods 158 patients of FHN,who underwent anteroposterior view and frog lateral view of X-ray and CT examinations of hip joint during the same period,staged as ARCO 3A by CT from January 2017 to July 2023 were retrospectively analyzed,of which 14 patients with bilateral ARCO stage 3A,so a total of 172 cases(F/M=67/91,average age:43.7±11.8 years)were included.The anteroposterior view and frog lateral view of X-ray standard radiographs of hip joint were observed for ARCO staging and statistics.Results There were 139 cases staged as ARCO 3A,and 33 cases misstaged as ARCO 2 evaluated by radiography,and the accuracy was 80.8%.Referring to hip CT images of the same period,in the cases of radiography misstaging,6 cases(18.2%)of subchondral fractures,4 cases(12.1%)of necrotic area fractures,and 23 cases(69.7%)of femoral head local collapse were not found.Conclusion The accuracy of radiography for ARCO stage 3A of FHN is high,but there is still some misstaging.In clinical work,anteroposterior view combined with frog lateral view,careful observation and identification of local slight collapse of articular surface and subchondral and necrotic area fractures is helpful to improve the accuracy of radiography for ARCO stage 3A of FHN.

关键词

股骨头坏死/ARCO/3A期/X线/CT/分期

Key words

Femoral Head Necrosis/ARCO Stage 3A/Radiography/CT/Staging

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基金项目

北京联影智能影像技术研究院项目(CRIBJQY202109)

中国中医科学院科技创新工程项目(9323015)

出版年

2024
中国CT和MRI杂志
北京大学深圳临床医学院 北京大学第一医院

中国CT和MRI杂志

CSTPCD
影响因子:1.578
ISSN:1672-5131
参考文献量15
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