中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
6期
515-520
,共6页
李子荣%刘朝晖%孙伟%史振才%王佰亮%赵凤朝%岳德波%杨雨润%程立明%王卫国%张启栋%郭万首
李子榮%劉朝暉%孫偉%史振纔%王佰亮%趙鳳朝%嶽德波%楊雨潤%程立明%王衛國%張啟棟%郭萬首
리자영%류조휘%손위%사진재%왕백량%조봉조%악덕파%양우윤%정립명%왕위국%장계동%곽만수
股骨头坏死%预后%预测%磁共振成像
股骨頭壞死%預後%預測%磁共振成像
고골두배사%예후%예측%자공진성상
Femur head necrosis%Prognosis%Forecasting%Magnetic resonance imaging
目的 通过分析非创伤性股骨头坏死的进展规律,创建新的股骨头坏死分型方法.方法 基于Herring对Legg-Perthes病的三柱概念,将冠状面股骨头分为内侧柱、中央柱及外侧柱,选择MR检查T1WI冠状位正中层面图像,依据坏死灶占据三柱结构的位置,建立中日友好医院(China-Japan Friendship Hospital,CJFH)股骨头坏死分型体系.依据此分型方法及日本骨坏死研究会(Japanese InVestigation Committee,JIC)分型分别对严重急性呼吸综合征患者的股骨头坏死(153髋)进行分型,统计其自然转归,比较两种分型方法的坏死塌陷率.结果 CJFH分型:内侧型(A型),坏死灶累及内侧柱；中央型(B型),坏死灶累及中央柱和内侧柱；外侧型(C型):凡累及外侧柱的坏死.依据坏死灶累及外侧柱的不同位置将外侧型分为次外侧型(C1型)、极外侧型(C2型)及全股骨头型(C3型).股骨头坏死患者自然进展显示,两种分型方法的A、B、C三型股骨头塌陷率不同；CJFH分型C3型塌陷率94.4％,C2型塌陷率100％,均高于C1型42.6％; CJFH分型C2、C3型合并塌陷率95.3％,高于JIC分型C2型塌陷率72.3％.差异均有统计学意义.结论 CJFH分型C2、C3型预测股骨头塌陷的敏感性高于JIC分型C2型.基于三柱结构的CJFH分型对股骨头坏死预后的预测准确性高,应用简便.
目的 通過分析非創傷性股骨頭壞死的進展規律,創建新的股骨頭壞死分型方法.方法 基于Herring對Legg-Perthes病的三柱概唸,將冠狀麵股骨頭分為內側柱、中央柱及外側柱,選擇MR檢查T1WI冠狀位正中層麵圖像,依據壞死竈佔據三柱結構的位置,建立中日友好醫院(China-Japan Friendship Hospital,CJFH)股骨頭壞死分型體繫.依據此分型方法及日本骨壞死研究會(Japanese InVestigation Committee,JIC)分型分彆對嚴重急性呼吸綜閤徵患者的股骨頭壞死(153髖)進行分型,統計其自然轉歸,比較兩種分型方法的壞死塌陷率.結果 CJFH分型:內側型(A型),壞死竈纍及內側柱；中央型(B型),壞死竈纍及中央柱和內側柱；外側型(C型):凡纍及外側柱的壞死.依據壞死竈纍及外側柱的不同位置將外側型分為次外側型(C1型)、極外側型(C2型)及全股骨頭型(C3型).股骨頭壞死患者自然進展顯示,兩種分型方法的A、B、C三型股骨頭塌陷率不同；CJFH分型C3型塌陷率94.4％,C2型塌陷率100％,均高于C1型42.6％; CJFH分型C2、C3型閤併塌陷率95.3％,高于JIC分型C2型塌陷率72.3％.差異均有統計學意義.結論 CJFH分型C2、C3型預測股骨頭塌陷的敏感性高于JIC分型C2型.基于三柱結構的CJFH分型對股骨頭壞死預後的預測準確性高,應用簡便.
목적 통과분석비창상성고골두배사적진전규률,창건신적고골두배사분형방법.방법 기우Herring대Legg-Perthes병적삼주개념,장관상면고골두분위내측주、중앙주급외측주,선택MR검사T1WI관상위정중층면도상,의거배사조점거삼주결구적위치,건립중일우호의원(China-Japan Friendship Hospital,CJFH)고골두배사분형체계.의거차분형방법급일본골배사연구회(Japanese InVestigation Committee,JIC)분형분별대엄중급성호흡종합정환자적고골두배사(153관)진행분형,통계기자연전귀,비교량충분형방법적배사탑함솔.결과 CJFH분형:내측형(A형),배사조루급내측주；중앙형(B형),배사조루급중앙주화내측주；외측형(C형):범루급외측주적배사.의거배사조루급외측주적불동위치장외측형분위차외측형(C1형)、겁외측형(C2형)급전고골두형(C3형).고골두배사환자자연진전현시,량충분형방법적A、B、C삼형고골두탑함솔불동；CJFH분형C3형탑함솔94.4％,C2형탑함솔100％,균고우C1형42.6％; CJFH분형C2、C3형합병탑함솔95.3％,고우JIC분형C2형탑함솔72.3％.차이균유통계학의의.결론 CJFH분형C2、C3형예측고골두탑함적민감성고우JIC분형C2형.기우삼주결구적CJFH분형대고골두배사예후적예측준학성고,응용간편.
Objective To explore the regular progressive pattern of nontraumatic osteonecrosis of the femoral head (ONFH) in order to establish the reliable and convenient new classification of ONFH.Methods The coronal section of the femoral head was divided into three pillars (medial,central and lateral).The mid-coronal section of the femoral head on MRI was selected.The China-Japan Friendship Hospital (CJFH)classification of ONFH was established according to the site of necrotic focus in three pillars.A total of 153hips with ONFH were classified according to CJFH classification and Japanese Investigation Committee (JIC)classification,respectively.The collapse rate was observed and compared between both classifications of ONFH.Results The CJFH classification for ONFH consists of 3 types:type A,the medial pillar was involved; type B,the medial and central pillars were involved; type C,the lateral pillar was involved.According to site of necrosis focus in the lateral pillar,the type C was divided into 3 types:C1,there pillars were involved but there still was some normal tissue in lateral pillar;,C2,partial central pillar and all lateral pillar were involved; C3,the whole femoral head was involved.The natural history of the ONFH showed the collapse rate of type C2 and C3 in CJFH classification (95.3％) was higher than that (72.3％) of type C2 in JIC classification.Conclusion The CJFH classification of ONFH based on three pillars is more sensitive than JIC classification in predicting collapse of the femoral head.Moreover,the CJFH classification is convenient to use.
