MRI检查对早期股骨头缺血坏死检出率的影响

*通讯作者：付真真，1986年9月，女，汉族，河南襄城人，现就职于襄城县人民医院磁共振室，主治医师，本科。研究方向：CT、MRI。

摘要：目的：探讨磁共振成像（MRI）检查在早期股骨头缺血坏死检出率中的应用价值。方法：选取2018年6月至2020年6月我院收治的疑似早期股骨头缺血坏死患者116例，均行计算机断层扫描（CT）、MRI及手术病理检查，以手术病理检查为“金标准”，对比CT、MRI诊断阳性检出率、准确率、敏感性、特异度。结果：MRI 阳性检出率63.79%与CT 54.31%比较，差异不显著（P > 0.05）;MRI诊断早期股骨头缺血坏死准确率88.79%、敏感性90.67%较CT 74.14%、72.00%高（P < 0.05）;MRI诊断早期股骨头缺血坏死特异度85.37%，与CT 78.05%比较，差异不显著（P > 0.05）。结论：MRI检查诊断早期股骨头缺血坏死准确率、敏感性高，更适合应用于临床诊断，值得临床应用推广。

关键词：磁共振成像;计算机断层扫描;早期股骨头缺血坏死;准确率

Abstract： Objective： To explore the application value of magnetic resonance imaging （MRI） in the detection rate of early avascular necrosis. Methods： 116 patients with suspected early avascular necrosis treated in our hospital from June 2018 to June 2020 were selected for computed tomography （CT）， MRI and surgical pathology. Taking surgical pathology as the “gold standard”， the positive detection rate， accuracy， sensitivity and specificity of CT and MRI were compared. Results： The positive detection rate was 63.79% of MRI and 54.31% of CT（P > 0.05）; The accuracy and sensitivity of MRI in the diagnosis of early avascular necrosis of femoral head were 88.79% and 90.67%， which were higher than those of CT： 74.14% and 72.00% （P < 0.05）; The specificity of MRI in the diagnosis of early avascular necrosis was 85.37%， which was not significantly different from that of CT： 78.05% （P > 0.05）. Conclusion： MRI has high accuracy and sensitivity in the diagnosis of early avascular necrosis， which is more suitable for clinical diagnosis and worthy of clinical application.

Keywords： MRI; Computed tomography; Early avascular necrosis; Accuracy

一、前言

早期股骨头缺血坏死属髋关节疾病，主要因骨组织缺血，引发骨组织内营养血流减少、血管网受压及流出静脉阻塞，造成骨内血液供给出现障碍，严重可导致患者骨组织缺血性坏死[1]。股骨头缺血坏死可产生一定疼痛，若未及时诊断治疗可造成骨头永久变形，严重影响患者健康及生活质量。早期股骨头缺血坏死无特异性症状，诊断难度较大，多数患者发现时已至晚期，仅能接受股骨头置换术治疗。因此，提高早期股骨头缺血坏死诊断，对患者具有重要意义。目前，临床主要以计算机断层扫描（CT）、磁共振成像（MRI）为主要影像学检查手段，其中CT可实现多层面连续扫描，有效判断股骨头是否存在脱位情况;而MRI可准确显示、定位股骨头病变组织，分辨率较高[2]。……