Watson Rohan M, Roach Neil A, Dalinka Murray K
Division of Musculoskeletal Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Radiol Clin North Am. 2004 Jan;42(1):207-19. doi: 10.1016/S0033-8389(03)00166-0.
MR imaging is the most accurate modality for the diagnosis of AVN, bone marrow edema syndrome, and femoral head insufficiency fractures. When the particular demographics of the patient are considered, the specificity of this examination is high. The reported success rates of joint-sparing operative intervention are variable. When compared with conservative management, the outcome of joint-sparing operative intervention in patients who have early (stage I, II) AVN lesions is improved. This is impetus for screening programs for patients who are known to be at high risk for AVN, such as patients who have undergone renal transplants and others who are on long-term, high-dose corticosteroid treatment. There is strong evidence that bone marrow edema syndrome (TO) is a distinct entity with demonstrable unique histopathology and well-defined demographics. Increased spatial resolution revealed typical subchondral findings of AVN in lesions that were once believed to represent irreversible TO. SIF of the femoral head is a new concept with a seemingly distinct population and with clinical presentation and imaging characteristics that should permit its differentiation from AVN.
磁共振成像（MR成像）是诊断股骨头缺血性坏死（AVN）、骨髓水肿综合征和股骨头不全骨折最准确的检查方法。考虑到患者的特定人口统计学特征时，该项检查的特异性较高。报道的保关节手术干预成功率各不相同。与保守治疗相比，早期（I期、II期）AVN病变患者保关节手术干预的效果有所改善。这推动了针对已知AVN高危患者的筛查项目，如接受肾移植的患者以及其他长期接受大剂量皮质类固醇治疗的患者。有强有力的证据表明，骨髓水肿综合征（TO）是一个具有可证实的独特组织病理学和明确人口统计学特征的独特实体。更高的空间分辨率揭示了曾被认为代表不可逆TO的病变中AVN典型的软骨下表现。股骨头不全骨折（SIF）是一个新概念，其患者群体似乎不同，临床表现和影像学特征应有助于将其与AVN区分开来。
