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ARCO 2-4期股骨头坏死MR征象对Harris评分影响分析
Hits: 818   Download times: 261   Received:February 21, 2023    
作者Author单位UnitE-Mail
史珊 SHI Shan 中国中医科学院广安门医院放射科, 北京 100053
首都医科大学附属北京友谊医院, 北京 100050		 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China		  
杨学东 YANG Xue-dong 中国中医科学院广安门医院放射科, 北京 100053 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
罗萍 LUO Ping 中国中医科学院广安门医院放射科, 北京 100053 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
方继良 FANG Ji-liang 中国中医科学院广安门医院放射科, 北京 100053 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
孙黎 SUN Li 中国中医科学院广安门医院放射科, 北京 100053 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
谢利民 XIE Li-min 中国中医科学院广安门医院骨科, 北京 100053 Department of Orthopaedics, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
于潼 YU Tong 中国中医科学院广安门医院骨科, 北京 100053 Department of Orthopaedics, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China  
王振常 WANG Zhen-chang 首都医科大学附属北京友谊医院, 北京 100050 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China cjr.wzhch@vip.163.com 
期刊信息：《中国骨伤》2023年36卷，第12期，第1185-1190页
DOI：10.12200/j.issn.1003-0034.2023.12.015
基金项目:北京联影智能影像技术研究院基金(编号:CRIBJQY- 202109);中国中医科学院科技创新工程项目(编号:CI2021A03302,CI2021A03320);中国中医科学院广安门医院护航工程-骨干人才培育项目(编号:9323015)


目的:分析并确定ARCO 2-4期股骨头坏死(osteonecrosis of femoral head,ONFH)对Harris评分有影响意义的MR征象。

方法:回顾性分析2019年1月至2020年6月34例行常规MR、T2 mapping、3D-SPACE序列检查及Harris评分的ARCO 2-4期ONFH患者,排除3例,最终纳入31例,男23例,女8例,年龄18~62(40.0±10.8)岁;其中21例为双侧ONFH,共计52个ONFH,ARCO 2期17个,ARCO 3期24个,ARCO 4期11个。在医院数字影像信息系统(picture archiving and communication system,PACS)对MR影像征象(股骨头塌陷深度、ONFH指数、骨髓水肿、股骨头骨质增生、软骨损伤分级、软骨T2值及关节积液)进行评估及测量,在Siemens后处理工作站计算软骨定量参数T2值并测量。采用Pearson相关分析评估MR各征象与Harris评分的相关性,采用多重线性回归分析评估与Harris评分有相关性的MR征象对Harris评分的影响。

结果:Pearson 相关分析显示股骨头塌陷深度(r=-0.563,P=0.000)、软骨损伤分级(r=-0.500,P=0.000)及关节积液(r=-0.535,P=0.000)与Harris评分呈负相关。多重线性回归分析显示关节积液(β=-6.198,P=0.001)、股骨头塌陷深度(β=-4.085,P=0.014)对Harris评分呈负相关。

结论:关节积液、股骨头塌陷深度对Harris评分有显著的负向影响关系,建议影像医师常规对股骨头塌陷深度、关节积液进行定量及等级评估,以高效精准地辅助临床诊疗。
[关键词]:股骨头坏死  Harris评分  MR征象  软骨损伤分级
 
Analysis of influence of MR signs on Harris hip score in ARCO stages 2-4 femoral head necrosis
Abstract:

Objective To analysis and determine MR signs of Harris score ARCO stages 2-4 in osteonecrosis of femoral head (ONFH).

Methods Thirty-four patients with ONFH of ARCO stages 2 to 4 who underwent routine MR,T2 mapping,3D-SPACE sequence examination and Harris score were retrospectively collected from January 2019 to June 2020,and 3 patients were excluded,and 31 patients were finally included,including 23 males and 8 females,aged from 18 to 62 years old with an average of(40.0±10.8) years old. Among them 21 patients with bilateral femoral head necrosis,totally 52 cases,including 17 with ARCO stage 2 patients,24 ARCO stage 3,and 11 ARCO stage 4. MR imaging signs (femoral head collapse depth,ONFH index,bone marrow edema,hyperplasia,grade and T2 value of cartilage injury,and joint effusion) were scored and measured on the picture archiving and communication system (PACS) workstation,and the cartilage quantitative parameter T2 value was calculated and measured on Siemens postprocessing workstation. Pearson correlation analysis was used to evaluate the correlation between various MR signs and Harris score,and then multiple linear regression analysis was used to examine impact of MR signs on Harris hip score.

Results Femoral head collapse depth(r=-0.563,P=0.000),grade of cartilage injury(r=-0.500,P=0.000),and joint effusion (r=-0.535,P=0.000) were negatively correlated with Harris score by Pearson correlation analysis. Multiple linear regression analysis showed that joint effusion(β=-6.198,P=0.001) and femoral head collapse depth(β=-4.085,P=0.014) had a significant negative impact on Harris hip score.

Conclusion Femoral head collapse depth and joint effusion both had significant negative relationship with Harris hip score. It is recommended to routinely evaluate femoral head collapse depth and joint effusion quantitatively and gradedly,so as to efficiently and accurately assist clinical diagnosis and treatment.
KEYWORDS:Femoral head necrosis  Harris hip score  MR signs  Grade of cartilage injury
 
引用本文，请按以下格式著录参考文献：
中文格式:史珊,杨学东,罗萍,方继良,孙黎,谢利民,于潼,王振常.ARCO 2-4期股骨头坏死MR征象对Harris评分影响分析[J].中国骨伤,2023,36(12):1185~1190
英文格式:SHI Shan,YANG Xue-dong,LUO Ping,FANG Ji-liang,SUN Li,XIE Li-min,YU Tong,WANG Zhen-chang.Analysis of influence of MR signs on Harris hip score in ARCO stages 2-4 femoral head necrosis[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1185~1190
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