Turner D A, Templeton A C, Selzer P M, Rosenberg A G, Petasnick J P
Department of Diagnostic Radiology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612.
Radiology. 1989 Apr;171(1):135-40. doi: 10.1148/radiology.171.1.2928517.
Six painful hips in five patients were examined with magnetic resonance (MR) imaging and were found to have diffuse signal abnormalities in the marrow of the femoral head and neck, which extended into the intertrochanteric area in five cases. The abnormal regions were low in signal intensity on images obtained with a short repetition time (TR) and a short echo time (TE) and were isointense or hyperintense on long TR/TE images--findings that have been attributed by others to bone marrow edema. Edema was also seen in marrow just above the acetabulum in two cases. No focal abnormalities characteristic of osteonecrosis were seen. Osteonecrosis was subsequently shown to be present in all six femoral heads at core biopsy (three cases) or by subsequent development of focal MR abnormalities reported to be highly specific for osteonecrosis (three cases). The affected hips had been radiographically normal or subtly osteopenic and had shown intense radionuclide uptake in the femoral head at scintigraphy, with lesser abnormality in the neck and intertrochanteric region. Follow-up MR examinations of five of the six femoral heads showed the diffuse abnormalities to have been transient. Although diffuse MR abnormalities in the proximal femur are not specific, they may indicate the presence of osteonecrosis of the femoral head.
对5例患者的6个疼痛髋关节进行了磁共振（MR）成像检查，发现股骨头和股骨颈骨髓存在弥漫性信号异常，其中5例延伸至转子间区域。在短重复时间（TR）和短回波时间（TE）获得的图像上，异常区域信号强度较低，而在长TR/TE图像上呈等信号或高信号——其他人将这些表现归因于骨髓水肿。2例患者髋臼上方骨髓也可见水肿。未发现骨坏死的局灶性异常特征。随后，通过核心活检（3例）或随后出现据报道对骨坏死具有高度特异性的局灶性MR异常（3例），证实所有6个股骨头均存在骨坏死。受影响的髋关节X线片表现正常或轻度骨质减少，骨闪烁显像显示股骨头有强烈的放射性核素摄取，颈部和转子间区域异常较轻。对6个股骨头中的5个进行的随访MR检查显示，弥漫性异常是短暂的。虽然股骨近端的弥漫性MR异常并不具有特异性，但它们可能提示股骨头存在骨坏死。
