CAJ | 학술논문

目的：通过MRI检查研究激素性股骨头坏死与股骨头、颈部骨髓脂肪含量的关系。方法对18周岁以上，无任何髋关节疾病及糖皮质激素治疗病史的27例患者（其中类风湿性关节炎12例，强直性脊柱炎10例，肾移植5例），在正规糖皮质激素治疗前后作MRI检查并进行随访，包括糖皮质激素治疗前基础MRI检查及糖皮质激素治疗后（基础MRI检查后）25、50周共2次随访MRI检查。采用GE/AW4.2工作站提供的T1信号值测量软件对基础MRI检查的股骨头、颈部骨髓进行T1信号值测量；MRI显示股骨头坏死者均经活检病理检查证实。结果4例发生股骨头坏死（左右侧各2例）。所有患者左右侧股骨头、颈部大范围平均T1信号值均无明显统计学差异（均P＞0.05）。发生股骨头坏死者的股骨头、颈部大范围平均T1信号值均较无股骨头坏死者明显减小，差异均有统计学意义（均P＜0.05）。结论激素性股骨头坏死的发生与激素治疗前的股骨头、颈部骨髓高脂肪含量有关。
목적：통과MRI검사연구격소성고골두배사여고골두、경부골수지방함량적관계。방법대18주세이상，무임하관관절질병급당피질격소치료병사적27례환자（기중류풍습성관절염12례，강직성척주염10례，신이식5례），재정규당피질격소치료전후작MRI검사병진행수방，포괄당피질격소치료전기출MRI검사급당피질격소치료후（기출MRI검사후）25、50주공2차수방MRI검사。채용GE/AW4.2공작참제공적T1신호치측량연건대기출MRI검사적고골두、경부골수진행T1신호치측량；MRI현시고골두배사자균경활검병리검사증실。결과4례발생고골두배사（좌우측각2례）。소유환자좌우측고골두、경부대범위평균T1신호치균무명현통계학차이（균P＞0.05）。발생고골두배사자적고골두、경부대범위평균T1신호치균교무고골두배사자명현감소，차이균유통계학의의（균P＜0.05）。결론격소성고골두배사적발생여격소치료전적고골두、경부골수고지방함량유관。
Objective To investigate the relationship between bone marrow fat content of femoral head- neck and femoral head osteonecrosis in corticosteroid- treated patients. Methods Twenty seven patients aged above 18 years, with rheumatoid arthritis (n=12), ankylosing spondylitis (n=10) or renal transplantation (n=5), who had no history of hip disorders and previous corticosteroid treatment, underwent corticosteroid treatment. MRI examinations were performed before and 25, 50 weeks after the initiation of corticosteroid therapy. The bulk T1 signal intensity values were measured by GE/AW4.2 work station. If MRI showed femoral head osteonecrosis, the pathology examination was fol owed. t test was used (P<0.05) for statistical analysis. Results Four patients developed lateral femoral head osteonecrosis (2 in right and 2 in left)at week 25. The mean base T1 value of femoral head- neck before corticosteroid treatment was significantly shorter in femoral head osteonecrosis than that in normal femoral head (P<0.05). Conclusion The development of corticosteroid associated femoral head osteonecrosis is correlated with a high fat content in the marrow of femoral head- neck before corticosteroid therapy.