대퇴골두괴사의 자기공명영상 (진단적 가치 및 조직학적 비교)

Abstract

Osteonecrosis of the femoral is an unsolved problem in the orthopaedic field, requiring eventual replacement surgery. But Ficat reported that early lesions such as stage 0, I and II lesions are reversible with adequate treatment. Therefore early diagnosis is the most important factor in obtaining the best results. Ninety-five consecutive patients with osteonecrosis of the femoral head were checked with MR imaging from 1989 to 1992, and the results were compared to those of conventional radiographs and bone scans. In five cases MR imaging and histologic sections were performed on the femoral head obtained from surgery, and we compaired the MR findings with those of histologic sections. The conclusions are as follows; l. Of the 95 patients with osteonecrosis of the femoral head, 88 cases were male, 7 cases were female, 23 cases were unilateral and 72 cases had bilateral hip involve- ment. The average age was 45.5 years. 2. Thirty-one hip at radionuclide imaging appeared normal when MR results distinctly abnormal. Therefore MR imaging is an excellent technique in detecting early osteonecrosis of the femoral head. 3. MR imaging provides an analysis in the extended volume and the anatomical location in three dimensions, then the biopsy site was accurately localized during core biopsy. The histological changes associated with osteonecrosis correspond very well with MR imaging. MR imaging is a sensitive technique for evaluating the effect of the head saving procedure such as core decompression.