Halland A M, Klemp P, Botes D, Van Heerden B B, Loxton A, Scher A T
Department of Internal Medicine, University of Stellenbosch, Parow, Cape Town, Republic of South Africa.
Br J Rheumatol. 1993 Nov;32(11):972-6. doi: 10.1093/rheumatology/32.11.972.
The value of magnetic resonance imaging (MRI) in the early diagnosis of avascular necrosis (AVN) of the hip in SLE was investigated. Twenty females with severe SLE were studied prospectively. Each underwent 6-monthly X-rays, technetium -99m (Tc-99m) pyrophosphate bone scans and MRI of the hips over a 3-yr period. AVN was diagnosed in five hips of three patients (15%) during the study period. It was confirmed histologically in three hips of two patients who underwent core decompression. Radiological evidence of AVN was present in two patients at diagnosis. One patient developed progressive radiological changes despite core decompression. Bone scintigraphy was abnormal at some stage in all three patients with AVN however failed to detect the early ischaemic stage of AVN. MRI was the most reliable investigation and was able to detect asymptomatic AVN prior to the appearance of radiological or scintigraphic abnormalities.
研究了磁共振成像（MRI）在系统性红斑狼疮（SLE）患者早期诊断髋关节缺血性坏死（AVN）中的价值。对20名重度SLE女性患者进行了前瞻性研究。在3年期间，每位患者每6个月进行一次髋关节X线检查、锝-99m（Tc-99m）焦磷酸盐骨扫描和MRI检查。在研究期间，3名患者的5个髋关节被诊断为AVN（15%）。在接受髓芯减压的2名患者的3个髋关节中，经组织学证实为AVN。2例患者在诊断时存在AVN的影像学证据。1例患者尽管接受了髓芯减压，但仍出现了进行性影像学改变。所有3例AVN患者在某些阶段骨闪烁显像均异常，但未能检测到AVN的早期缺血阶段。MRI是最可靠的检查方法，能够在影像学或闪烁显像异常出现之前检测到无症状的AVN。
