成人股骨头缺血性坏死的早期CT诊断

摘要

Objective:To study the early CT fingdings of avascular necrosis of femoral head (AvNFH)in adults. Methods:The CT and X-ray findings of 28 hip joints of AvNFH in 20 cases diagnosed by pathology or follow-up check, were retrospectively analyzed. Results: No defmete changes in shape of femoral head were demonstrated on plain film as well as on CT in all 28 hip joints. Plain films showed local cortical thickening and sclerosis of femoral heads in 4 hip joints. CT scans demonstrated distorted trabeculae in 15 femoral heads,and polymorphous high density sclerosis in 12,and in 3 of the 12 there was also low density area. CT scans also documented osteosclerosis in the cortical edge of 4 femoral heads. Conclusion:Disappearance of the "asterisk sign" and appearance of high density osteosclerosis in various shapes are early CT features of AvNFH.%目的：探讨成人股骨头缺血性坏死(AvNFH)的早期CT表现。方法：回顾性分析经病理或随访证实的20例28个髋股骨头外形完整的成人AvNFH的平片及CT片，分析其征象及变化。结果：28个股骨头均完整，平片仅显示4个股骨头皮质局限性增厚、硬化。CT扫描15个股骨头显示骨小梁扭曲，12个股骨头内见多种形态高密度硬化区，其中3个股骨头合并低密度区。4个股骨头见边缘皮质硬化。随访病例股骨头密度及外形表现出一定规律。结论：股骨头内"星芒征"消失，出现多种形态的高密度硬化区是本病的CT早期征象。