Predictive value of magnetic resonance imaging for multifocal osteonecrosis screening associated with glucocorticoid therapy.
Predictive value of magnetic resonance imaging for multifocal osteonecrosis screening associated with glucocorticoid therapy.
复制标题
磁共振成像对糖皮质激素治疗相关多灶性骨坏死筛查的预测价值。
DOI：
10.1080/14397595.2019.1623363
复制
发表时间：
2019
期刊：
影响因子：
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通讯作者：
Ohtori S.
中科院分区：
文献类型：
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作者：
Nawata K;Nakamura J;Hagiwara S;Wako Y;Miura M;Kawarai Y;Sugano M;Yoshino K;Inage K;Orita S;Ohtori S.
目的：本研究的目的是利用磁共振成像（MRI）阐明与糖皮质激素治疗相关的多灶性骨坏死的分布情况，并建立MRI筛查方法。方法：1986年至2018年间，107例患者在全身糖皮质激素治疗后进行髋、膝、肩、踝关节（共856个关节）的MRI筛查。结果：观察到骨坏死情况髋关节（68%）、膝关节（44%）、踝关节（17%）和肩关节（15%）。双侧髋部骨坏死的患者很可能双侧膝部骨坏死，而双侧髋部无骨坏死的患者不太可能双侧膝部骨坏死 (p= .0299)。当患者的髋关节和膝关节均未出现骨坏死时，踝关节或肩关节的骨坏死并不明显。结论：在这项研究中，MRI（作为与糖皮质激素治疗相关的多灶性骨坏死的筛查方法）显示，首先受影响的部位是臀部和膝盖，其次是脚踝和肩膀。如果髋关节和膝关节没有骨坏死，则无需对脚踝和肩部进行进一步筛查。在髋关节和/或膝关节中观察到的任何骨坏死都需要对脚踝和肩部进行第二次 MRI 筛查。
Objectives:The goals of this study were to elucidate the distribution of multifocal osteonecrosis associated with glucocorticoid therapy using magnetic resonance imaging (MRI) and to establish a MRI screening method.Methods:Between 1986 and 2018, 107 patients underwent MRI screening of their hips, knees, shoulders and ankle joints (856 joints in total) after systemic glucocorticoid therapy.Results:Osteonecrosis was observed in hip (68%), knee (44%), ankle (17%) and shoulder (15%) joints. Patients with bilateral osteonecrosis in their hips were likely to have bilateral osteonecrosis in their knees, whereas patients without osteonecrosis in both hips were unlikely to have osteonecrosis in both knees (p= .0299). Osteonecrosis was never evident in the ankle or shoulder joints when a patient did not have osteonecrosis in both hip and knee joints.Conclusion:In this study, MRI – as a screening method for multifocal osteonecrosis associated with glucocorticoid therapy – showed the sites affected first are hips and knees followed by ankles and shoulders. If osteonecrosis is absent in hip and knee joints, further screening of the ankles and shoulders is unnecessary. Any osteonecrosis observed in the hip and/or the knee joints warrants a second MRI screening of the ankles and shoulders.