Beltran J, Knight C T, Zuelzer W A, Morgan J P, Shwendeman L J, Chandnani V P, Mosure J C, Shaffer P B
Department of Radiology, Ohio State University Hospitals, Columbus 43210.
Radiology. 1990 May;175(2):533-6. doi: 10.1148/radiology.175.2.2326478.
A long-term radiographic follow-up study was conducted on 24 patients (34 hips) who underwent core decompression of the femoral head for avascular necrosis (AVN). The purpose of the study was to assess the potential correlation between the extent of AVN, as determined with preoperative magnetic resonance (MR) imaging, and development of collapse. The preoperative MR results were classified into four categories: group A, no AVN; group B, less than 25% involvement of the weight-bearing portion of the femoral head; group C, 25%-50% involvement; and group D, more than 50% involvement. Histologic evidence of AVN was found in all 34 hips. Collapse occurred in none of the hips in groups A and B (n = 12), in three of seven hips (43%) in group C, and in 13 of 15 hips (87%) in group D. It is concluded that MR estimation of the extent of femoral head involvement with AVN may help in predicting which femoral heads will collapse shortly after core decompression, so that this invasive procedure can be avoided in patients at risk.
对24例（34髋）因股骨头缺血性坏死（AVN）接受股骨头髓芯减压术的患者进行了长期影像学随访研究。本研究的目的是评估术前磁共振（MR）成像所确定的AVN范围与股骨头塌陷发展之间的潜在相关性。术前MR结果分为四类：A组，无AVN；B组，股骨头负重部分受累小于25%；C组，受累25%-50%；D组，受累超过50%。所有34髋均发现AVN的组织学证据。A组和B组（n = 12）的髋均未发生塌陷，C组7髋中有3髋（43%）发生塌陷，D组15髋中有13髋（87%）发生塌陷。结论是，通过MR评估股骨头AVN的受累范围可能有助于预测哪些股骨头在髓芯减压术后不久会发生塌陷，从而可避免对有风险的患者进行这种侵入性手术。
