资源描述：
《股骨头坏死骨髓水肿的临床分析.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、股骨头坏死骨髓水肿的临床分析作者：刘少军【摘要】探讨股骨头坏死骨髓水肿(bonemarrowedema,BME)与临床症状和影像学改变的相关性。[方法]40例(70慨)股骨头坏死患者，通过MRI脂肪压抑图像确认BME,并对其分级：0级25髓(无BME),1级20骸(BME弥散在股骨头)，2级14髓(BME弥散在股骨头、颈)；3级11骸(BME弥散在股骨头、颈以及股骨近端)。分析BME与年龄，病因、ARCO分期、疼痛分组、坏死范围以及股骨头塌陷之I'可的相关性；运用多个独立样本非参数检验和列联表X2检验。[结果]BME与年龄、病
2、因无相关性；各分期中BME分级的差异有显著意义(X2=21.1,P=0.0003),各分期的BME发生有显著差异(X2=28.51,P<0.0001)；不同坏死范围中，BME分级有显著差异(X2=9.77,P=0.021),但BME的发生无显著差异(X2=6.227,P=0.101)；股骨头塌陷与BME分级无相关性(X2=2.558,P=0.465)，但BME的发生与股骨头塌陷有相关性(X2=22.799,P<0.001)；不同疼痛程度中BME分级有显著性差异(X2=26.66,P<0.001),BME的发生
3、与疼痛程度有相关性(X2=40.855,P<0.001)o[结论]BME的发生与年龄、病因无相关性;BME弥散程度与坏死范围、疼痛程度、股骨头塌陷存在相关性，BME的发生与坏死范围无关，与疼痛、塌陷密切相关；BME可能是由股骨头塌陷所导致的病理改变。【关键词】骨坏死股骨头骨髓核磁共振成像Abstract:[Objective]Toevaluatetherelationshipbetweentheclinicalsymptoms,imageologychangesandthebonemarrowedema(BME)inos
4、teonecrosisoffemoralhead(ONF)onmagneticresonanceimages(MRI).[Method]Thesubjectswere40patientswith70hipsshowingONF.BEMwasdiagnosedaccordingfatsuppressionimagesofMRI,associatedfocalanddiffuseBMEweregradedasgrade0with25hips(noBME),grade1with25hips(BMEdiffusetothefemora
5、lhead),grade2with14hips(BMEdiffusetothefemoralheadandneck),grade3with11hips(BMEdiffusetothefemoralheadandneck,proximalfemur).CorrelationofBMEwasevaluatedtoage,etiologicalfactor,stagesofONF,paingrade,theextentofONFandtocollapseofthefemoralhead.[Result]Therewasnocorre
6、lationofBMEtoageandtoetiologicalfactor.ThegradesofBMEcorrelatedsignificantlywiththestagesofONF(X2=2I.I,P=0.0003).ThepresenceofBMEcorrelatedsignificantlywiththestagesofONF(X2=28.51,P&k;0.0001).ThegradesofBMEcorrelatedsignificantlywiththeextentofONF(X2=9.77,P=0.021),b
7、uttherewasnocorrelationofthepresenceofBMEtotheextentofONF(X2=6.227,P=0.101).TherewasnocorrelationofthegradesofBMEtocollapseofthefemoralhead(X2=2.558,P=0.465),butthepresenceofBMEcorrelatedsignificantlywiththecollapse(X2=22.799,P<0.001).Ineachthegroupsofpain,thegra
8、desofBMEwasofgreatsignificantdifference(X2=26.66,P<0.001),thepresenceofBMEwasofgreatsignificantdifference(X2=40.855,P<0.001).[Conclu
