Imhof H, Breitenseher M, Trattnig S, Kramer J, Hofmann S, Plenk H, Schneider W, Engel A
Department of Osteology and MR Institute, Univ. Klinik f. Radiodiagnostik, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Eur Radiol. 1997;7(2):180-6. doi: 10.1007/s003300050131.
The etiology of avascular necrosis (AVN) is multifactorial. Independent of its etiology and localization it shows typical pathologies and radiological images. In the early stages localized subchondral edema is characteristic. In 50 % of all cases accompanying joint effusion may be found. Due to necrosis of the cells of bone marrow and bone fibrovascular, reactions with hyperemia can be delineated. These reactions allow us to visualize necrosis indirectly. The best imaging methods are MRI and, to a lesser extent, bone scintigraphy. In later stages calcification as well as new bone formation and microfractures are typically demonstrated and visualized best with plain X-rays and CT. Why reparations in many cases, particularly in the hip, are incomplete and may stop in any stage is unknown. Over years clinically complete silent AVNs are not an uncommon finding. Prognosis depends on the localization and size of the AVN. The number of repair mechanisms is best outlined with contrast-enhanced MRI and return of fatty marrow.
缺血性坏死（AVN）的病因是多因素的。无论其病因和部位如何，它都表现出典型的病理学和放射学影像。早期，局限性软骨下水肿是其特征。在所有病例中，50%可能会伴有关节积液。由于骨髓和骨纤维血管细胞的坏死，可以勾勒出充血反应。这些反应使我们能够间接观察到坏死。最佳的成像方法是MRI，骨闪烁显像的作用相对较小。在后期，钙化以及新骨形成和微骨折通常可以通过X线平片和CT清晰显示。为何在许多情况下，尤其是在髋关节，修复不完整且可能在任何阶段停止尚不清楚。多年来，临床上完全无症状的AVN并不少见。预后取决于AVN的部位和大小。通过对比增强MRI和脂肪骨髓的恢复可以最好地勾勒出修复机制的数量。
