Holman A J, Gardner G C, Richardson M L, Simkin P A
Department of Medicine, University of Washington, Seattle 98195, USA.
J Rheumatol. 1995 Oct;22(10):1929-33.
To determine whether the course of femoral head osteonecrosis after core decompression can be predicted from the extent of necrotic bone in the preoperative magnetic resonance imaging (MRI).
In 31 femoral head lesions (Ficat stage I or II), the percentage volume of necrotic bone was calculated by dividing the sum of the necrotic areas from all MRI slices by the sum of the femoral head areas. Osteonecrosis risk factors, pain scores, and the need for further surgery were assessed at a minimum of 12 mo post-core decompression. Clinical outcomes were considered good when post-core decompression pain scores improved and further surgery was not required.
Fourteen of the 15 hips with good outcomes after a mean followup of 32 mo had less than 21% femoral head involvement. All 16 hips with poor outcomes after a mean followup of 17 mo had more than 21% of the femoral head affected.
Quantitative MRI of femoral head necrosis was a useful predictor of clinical outcome following core decompression.
确定能否根据术前磁共振成像（MRI）中坏死骨的范围来预测经皮穿刺减压术后股骨头坏死的病程。
在31个股骨头病变（Ficat Ⅰ期或Ⅱ期）中，通过将所有MRI切片上坏死区域的总和除以股骨头区域的总和来计算坏死骨的体积百分比。在经皮穿刺减压术后至少12个月时评估骨坏死危险因素、疼痛评分以及进一步手术的必要性。当经皮穿刺减压术后疼痛评分改善且无需进一步手术时，临床结果被认为良好。
平均随访32个月后，15例预后良好的髋关节中有14例股骨头受累小于21%。平均随访17个月后，16例预后不良的髋关节中，所有病例股骨头受累均超过21%。
股骨头坏死的定量MRI是经皮穿刺减压术后临床结果的有用预测指标。
