Abstract
目的 探讨骨髓水肿(BME)与坏死区信号、关节液体量和临床症状的关系,进一步提高对其在股骨头缺血坏死(ONFH)中临床意义的认识.方法分析经病理或临床随访证实的57例91髋成人ONFH资料.全部病例摄有骨盆正位平片,并于1周内行双髋1.5 T MR检查和放射性核素骨显像.分别对股骨头皮质完整组、皮质断裂塌陷组和MRI不同信号坏死区组中的BME进行研究.结果具有线样征的88髋中,61髋其远侧区可见BME信号.BME在皮质完整的混杂信号坏死组中的出现率高于皮质完整的单纯脂肪样信号坏死组,而低于皮质断裂塌陷组(P 0.05),均大于皮质完整无BME组(P<0.01). 结论临床无症状患者大多无BME,而无BME且股骨头皮质完整的髋关节内多见少量液体.伴有BME的患者无论股骨头皮质是否断裂塌陷,髋关节内常见大量液体,临床大多具有症状.ONFH中出现BME或BME程度加重时,提示病情进展。
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