【摘要】 目的分析成人缺血性股骨头坏死影像学的特征分布情况。方法通过回顾性调查的方法,收集2004年1月至2005年12月在上海六院骨科接受手术治疗的股骨头坏死患者术前的X线、MRI等影像学资料及一般资料,共118例(男77例,女41例)患者,共164髋为研究对象,其中MRI资料为129髋。按照股骨头坏死Steinberg分期进行系统描述,分析股骨头坏死的面积、部位及塌陷与面积之间的关系等情况并进行相应的统计学处理。结果男、女平均年龄分别为36.69岁和36.05岁,患者不同性别的年龄间的差异无统计学意义。164例坏死股骨头中,其中Ⅰ期为3例,Ⅱ期34例,Ⅲ期27例,Ⅳ期93例,Ⅴ期7例,以Ⅲ、Ⅳ期为主(占73.17%)。在股骨头坏死区域的分布方面,位于股骨头上外侧、上外侧加头下靠近中央区等压力承重区域占76.83%(126例);在坏死面积方面,大于30%的坏死面积占84.15%(138例);在外形有塌陷方面,外形有塌陷者占60.98%(100例)。外形有塌陷者与非塌陷者在坏死面积方面比较,塌陷者坏死面积大,两者之间的差异有统计学意义(P<0.01)。MRI检查发现股骨头骨髓水肿的患者占39.56%,有股关节积液的患者占61.54%。结论本组患者在坏死分期方面以SteinbergⅢ、Ⅳ期为主(73.17%)。股骨头坏死主要集中在应力承重区域,本组138例患者(占84.15%)的坏死面积大于30%以上,坏死面积越大者外形越容易发生塌陷。更多还原

【Abstract】 Objective To explain the distrubtional characteristics on the adult avascular necrosis of the femoral head,and providing the basic data and reference for clinical diagnosis and management and evaluating its prognosis as well.Methods With the retrospective investigation,gathered and sorted the imaging materials and their demography information of 118 in-patients of osteonecrosis of femoral head between January 2004 and December 2005 in the department of orthopedics of the Shanghai 6th hospital.The subjects consisted of 77 males and 41 females with an average age of 36.45 years(ranged from 16.84 to 59.68 years) and there were 164 hips which including 129 MRI and 164 X-ray images.And describing systemic the imaging characteristics of the osteonecrosis according to the Steinberg classification,and lesion sizes and lesion locations and the relationship between the lesion sizes and collapse were analyzed.And then all data were analyzed by a commercially available statistical database package(SPSS 12.0).Results The means age of the male and female was 36.69 years and 36.05 years respectively and there was no statistics significant between them.In all of the 164 femoral heads there involved 3 hips in type Ⅰ and 34 hips in type Ⅱ and 27 hips in type Ⅲ and 93 hips in type Ⅳ and 7 hips in typeⅤ.And 73.17 percent of the hips consisted of type Ⅲ and type Ⅳ.76.83 percent(126 case) of the necrosis location was situated in the weight-bearing fields including the upper-outer region and the medial region nearby the subcartilage area.And there was 84.15 percent hips with lesion size of more than 30%.And 60.98%(100 case) of all of the femoral heads had been collapsed and there were highly statistic significant in the lesion sizes between the groups of collapsed and non-collapsed and lesion size was larger in the group of collapsed than the other group.The edema was 39.56% and effusion of the hip space was 61.54% detected from MRI.Conclusion Most of the cases were in the severe upgrading of the Steinberg classification of type Ⅲ and type Ⅳ.The remarkable field of the osteonecrosis of the femoral head was concentrated in the weight-bearing region of the femoral head,and majorities(84.15%) with lesion size were more than 30%,and then the larger lesion sizes were more susceptible to collapse.更多还原