Nidecker A
Röntgeninstitut; Insitut für MRI Rebgasse; Basel.
Orthopade. 1990 Aug;19(4):182-90.
Early diagnosis and treatment of avascular necrosis (AVN) of the femoral heads improve the prognosis of this disorder. Of the different radiological studies available so far, none has been truly satisfactory. Conventional X-rays frequently show alterations in the femoral heads only in later stages. Early on these may be so subtle that they are overlooked by the examiner. Bone scintigraphy is more sensitive than conventional X-rays in the detection of early alterations, but there are still up to 18% negative studies in biopsy-proven femoral-head necrosis. The sensitivity of this method is also diminished when bilateral AVN is present. This is frequently the case even if only one hip joint is symptomatic. Computed tomography (CT) and single photon emission computed tomography (SPECT) are highly sensitive methods that are still not widely used for the diagnosis of AVN. With SPECT, clinical experience is still limited. A number of publications in recent years have revealed the excellent characteristics of magnetic resonance imaging (MRI) in showing the pathological processes in bone marrow and, in particular, AVN. This paper summarizes a few of these publications and our personal experience with MRI in AVN of the femoral head. Different cases examples are given.
股骨头缺血性坏死（AVN）的早期诊断和治疗可改善该疾病的预后。在目前可用的不同放射学检查中，没有一种是真正令人满意的。传统X线片通常仅在后期才显示股骨头的改变。早期这些改变可能非常细微，以至于检查者会忽略它们。骨闪烁显像在检测早期改变方面比传统X线片更敏感，但在经活检证实的股骨头坏死中仍有高达18%的检查结果为阴性。当存在双侧AVN时，这种方法的敏感性也会降低。即使只有一个髋关节有症状，这种情况也很常见。计算机断层扫描（CT）和单光子发射计算机断层扫描（SPECT）是高度敏感的方法，但仍未广泛用于AVN的诊断。对于SPECT，临床经验仍然有限。近年来的一些出版物揭示了磁共振成像（MRI）在显示骨髓病理过程，特别是AVN方面的优异特性。本文总结了其中的一些出版物以及我们在股骨头AVN的MRI方面的个人经验。给出了不同的病例示例。
