摘要
目的 探讨骨髓水肿是否为非创伤性股骨头缺血坏死的早期MRI表现 ,并揭示骨髓水肿的原因和发生机制。方法 82例 (13 2髋 )确诊股骨头缺血坏死的病人 ,同时行X线、CT和MRI检查 ,从中挑选 45髋MRI上出现骨髓水肿的病例进行研究 ,并对其中 8髋进行MRI与组织学对照分析。结果 13 2髋中 ,骨髓水肿病例中 3 7髋可见骨皮质塌陷。骨髓水肿股骨头皮质塌陷组明显高于皮质完整组 (P <0 .0 0 1)。 8髋行活组织检查 ,其中右髋 2个 ,左髋 6个。组织学上 ,骨髓水肿对应处表现为新生纤维组织和间质水肿。结论 骨髓水肿代表股骨头缺血坏死的中晚期阶段 ,是病情进一步发展的标志。MRI上出现骨髓水肿提示临床需进行进一步检查。
Objective To clarify whether bone marrow edema is detectable on initial MR imaging of nontraumatic femoral head necrosis,and to discover the pathogenesis of bone marrow edema. Methods Eighty-two patients (132 hips) with known osteonecrosis were examined consecutively with MRI,CT and plain film. Forty five of the 132 hips with marrow edema on MRI were recruited. Eight resected specimens among them were studied by pathology and correlated with preoperative MRI with emphasis on the histopathological basis of marrow edema. Results Of the 132 hips,37 hips with bone marrow edema were observed in articular collapse. Bone marrow edema was more present in the collapse of the femoral head than none( P <0.001). Eight core biopsies were performed during surgery on two right and six left hips,consistent with bone marrow edema on MRI. All histologic sections in the bone marrow edema area showed exudates and fibroblastic proliferation in the medullary spaces. Conclusion Bone marrow edema means the later pathological phase of osteonecrosis. It should be considered as a marker for potential progression to advanced osteonecrosis and careful examinations are necessary when bone marrow is seen.
出处
《中国医学影像技术》
CSCD
2004年第4期503-505,共3页
Chinese Journal of Medical Imaging Technology
关键词
股骨头坏死
骨髓水肿
应力改变
股骨头塌陷
Femoral head necrosis
Bone marrow
Mechnical stress
Collapse of the femoral head
