股骨颈骨折不同分型的股骨头血流动力学MSCT灌注评价

【摘要】 目的 应用多层螺旋CT (MSCT)灌注成像评价股骨颈骨折不同骨折分型的股骨头血流动力学特点。方法 收集2018年1月至2019年6月31例单侧股骨颈骨折并行CT股骨头灌注成像患者的影像资料,分别进行Garden分型、Pauwels分型和解剖部位分型。统计各型血流量(BF)、血容量(BV)、强化峰值(PEI)、对比剂峰值时间(TTP),评价不同骨折分型的股骨头动脉血供和关节囊内压情况。结果Garden分型不同类型间CT灌注指标BF和PEI各型间差异有统计学意义(P<0.05);BV和TTP在各型间差异无统计学意义(P>0.05)。Pauwels各型间仅TTP差异有统计学意义(P<0.05),其余各项灌注指标差异无统计学意义(P>0.05)。按解剖部位分型,各型间两两比较差异有统计学意义(P<0.05)。结论 应用MSCT灌注成像评估不同类型股骨颈骨折患者股骨头血供,按解剖部位分型最能体现骨折后股骨头血供变化,Garden分型次之,Pauwels分型较难体现骨折后股骨头血流灌注情况。更多还原

【Abstract】 Objective To evaluate the hemodynamic characteristics of femoral head in different fracture types of femoral neck fractures by multi-slice spiral CT(MSCT) perfusion imaging.Methods 31 cases of unilateral femoral neck fracture with CT perfusion imaging of femoral head were collected from January 2018 to June 2019.Garden typing,Pauwels typing and anatomical site typing were performed respectively.The blood flow(BF),blood volume(BV),enhancement peak(PEI) and contrast agent peak time(TTP) of each type were calculated to evaluate the blood supply and internal pressure of the femoral head artery with different fracture types.Results The differences of CT perfusion indexes BF and PEI between different types of Garden classification were statistically significant(P<0.05).The differences between BV and TTP were not statistically significant(P>0.05).There were only statistically significant differences in TTP among Pauwels types(P<0.05),and no statistically significant differences in other perfusion indexes(P>0.05).The types were classified according to the anatomical sites,and the pairwise differences between the types were statistically significant(P<0.05).Conclusion MSCT perfusion imaging is used to evaluate the blood supply of femoral head in patients with different types of femoral neck fractures.The change of blood supply of femoral head after fracture is best reflected by the type of anatomical site,followed by the Garden type,and the Pauwels type is more difficult to reflect the blood perfusion of femoral head after fracture.更多还原