MRI in Distinguishing ARCO Stage Ⅱ from ⅢA of Osteonecrosis of the Femoral Head
10.3969/j.issn.1005-5185.2025.11.015
- VernacularTitle:MRI区分股骨头坏死ARCO Ⅱ期与ⅢA期的应用
- Author:
Shuhui YANG
1
;
Bentao YANG
;
Jiang PENG
;
Liutong SHANG
;
Jing LU
;
Yan ZHONG
;
Tianran LI
Author Information
1. 解放军总医院第四医学中心放射诊断科,北京 100048;首都医科大学附属北京同仁医院放射科,北京 1
- Publication Type:Journal Article
- Keywords:
Femur head necrosis;
Magnetic resonance imaging;
Tomography,X-ray computed;
ARCO stage Ⅱ;
ARCO stage ⅢA;
Diagnosis,differential
- From:
Chinese Journal of Medical Imaging
2025;33(11):1223-1229
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the application value of MRI in distinguishing Association Research Circulation Osseous(ARCO)stage II and IIIA of osteonecrosis of the femoral head.Materials and Methods A total of 48 patients with ARCO stage II/IIIA non-traumatic osteonecrosis of the femoral head in the Fourth Medical Center of Chinese PLA General Hospital from October 2022 to September 2023 were retrospectively included,with a total of 75 hips.The hips were divided into ARCO stage II group(26 hips)and stage IIIA group(49 hips)based on CT.The MRI findings(including irregular articular surface of femoral head,similar closed-loop shape of necrotic-viable interface,fibrous granulation tissue and cystic change in necrotic area,perinecrotic bone marrow edema,articular effusion and synovitis)were compared between the two groups,and the diagnostic efficiencies were evaluated.Results Irregular articular surface of femoral head,cystic change and fibrous granulation tissue in necrotic area and synovitis were more common in stage IIIA group than in stage II group,the range of bone marrow edema was larger than that in stage II group,the grade of articular effusion was larger than that in stage II group,and similar closed-loop shape of the necrotic-viable interface was found in stage II group,but no such sign was found in stage IIIA group,with statistical difference of all the above(χ2/Z=-5.727-54.764,all P<0.001).The area under the curve of irregular articular surface of femoral head,bone marrow edema,synovitis,articular effusion,fibrous granulation tissue in necrotic area,cystic change in the necrotic area,and similar closed-loop shape of the necrotic-viable interface in distinguishing ARCO stage II and IIIA were 0.931,0.891,0.845,0.799,0.772,0.724 and 0.692,respectively.The diagnostic efficiency of irregular articular surface of femoral head was not statistically significant with bone marrow edema and synovitis(both P>0.05),and higher than articular effusion,fibrous granulation tissue in necrotic area,cystic change in necrotic area,and similar closed-loop shape of the necrotic-viable interface(Z=2.054,2.711,4.182,4.003,all P<0.05).Conclusion MRI is helpful to distinguish ARCO stage II from stage IIIA of osteonecrosis of the femoral head.The diagnostic efficiencies of irregular articular surface of femoral head,bone marrow edema and synovitis are higher.
