| 裴京哲,赵涛,刘薇,屈辉.股骨颈骨折后继发股骨头缺血坏死的MRI诊断[J].中国医学影像技术,2004,20(4):496~499 |
| 股骨颈骨折后继发股骨头缺血坏死的MRI诊断 |
| MR imaging of avascular necrosis of the femoral head after transcervical fracture |
| |
| DOI： |
| 中文关键词: 股骨头坏死 股骨颈骨折 磁共振成像 |
| 英文关键词:Femur head necrosis Femoral neck fracture Magnetic resonance imaging |
| 基金项目: |
|
| 摘要点击次数: 2552 |
| 全文下载次数: 1464 |
| 中文摘要: |
| 目的 研究股骨颈骨折后继发股骨头缺血坏死的MRI影像学表现。方法 回顾14例有股骨颈骨折手术病史、经MRI证实为股骨头缺血坏死病人的MRI图像,分析其MRI影像表现并进行分型。结果 全部患者共14个部位。在T1WI、T2WI上,坏死区域10例表现为高T1中高T2信号;3例表现为斑片状低T1低T2信号;1例表现为大片状低T1混杂T2信号。骨折线表现为条状低T1稍高T2信号,钉道呈规则条状低T1低T2信号。 STIR序列上与坏死区邻近的股骨头和股骨颈的正常骨髓内13例可见弥漫性高信号, 1例为低信号。按照与股骨头缺血坏死塌陷有关的坏死面积的大小分为三型,其中Ⅰ型9例,表现为股骨头外上象限的小面积梗死;Ⅱ型2例,为股骨头上自外上象限至圆韧带窝的窄带状梗死区域;Ⅲ型3例,呈股骨头大面积梗死。14个病例中7例出现股骨头塌陷,其中Ⅰ型有4例,Ⅱ型有2例,Ⅲ型中有1例。14例X线平片均不能诊断股骨头坏死。结论 MRI在股骨颈骨折后继发股骨头缺血坏死的诊断中有重要价值,并且对坏死股骨头预后的判定有帮助。 |
| 英文摘要: |
| Objective To study the magntic resonance imaging of avascular necrosis of the femoral head after transcervical fracture. Methods A retrospective study of 14 patients with transcervical fracture of femur using MRI was done to detect evidence of avascular necrosis of the head. Grading was performed in unilateral femoral head of 14 cases. Results The infarcts of ten hips showed high signal intensity on T1WI and middle high signal intensity on T2WI; the infarcts of 3 hips showed macular low signal intensity on both T1WI and T2WI and of 1 hip displayed the flaky low signal on T1WI and mixed signal on T2WI. For fracture lines, MRI showed a band of low signal intensity on T1WI and a band of slightly high signal on T2WI. For screws, MRI showed a band of low signal intensity on both T1WI and T2WI. On STIR, osteonecrosis and the margines showed low signal intensity and normal marrow near the osteonecrosis showed diffuse high signal intensity in 13 cases except low signal intensity in one case. There were three patterns of infarction demarcated by MRI and the incidence of collapse of the femoral head correlated with size of the lesions: typeⅠwas a small infarct at superolateral region of the femoral head and was seen in nine hips; typeⅡwas a shallow lesion from the superolateral region to the fovea of the femoral head (2 hips); and type Ⅲwas a large lesion occupying most of the femoral head (3 hips). Collapse of the femoral head occurred in four hips with type-Ⅰlesions, both type-Ⅱhips and one of the three type-Ⅲ hips collapsed too. X-ray plain films of 14 patients can not show the appearance of osteonecrosis of the femoral head. Conclusion Magnetic resonance imaging is of great value in diagnosing avascular necrosis of the femoral head after transcervical fracture and of great help to make a prognostic factor for osteonecrosis of the femoral head. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
