人工髋关节置换术后并发症影像学表现

发布时间：2019-01-27 13:18

【摘要】：目的探讨人工髋关节置换术后并发症的影像学表现。方法回顾性分析28例(共31例次)人工髋关节置换术后出现并发症而接受髋关节翻修术患者,观察其影像学表现。结果 31例次中,术后诊断股骨头脱位4例次,X线平片表现为股骨头位于髋臼外;无菌性松动22例次,X线表现为假体周围2~30mm的透亮带,其中,假体周围慢性肉芽肿性炎CT/MRI表现为骨质破坏并软组织肿块;感染4例次,X线表现为假体周围2~4mm的轮廓与假体形态不一致的透亮带,MRI表现为感染区软组织肿胀,见环形强化病灶;异位骨化1例次,X线表现为髋臼假体周围软组织大量骨化影。结论假体周围透亮带是人工髋关节置换术后关节松动最重要的X线表现,CT/MRI有助于区分无菌性松动中的假体慢性肉芽肿性炎、以鉴别感染性和无菌性松动。
[Abstract]:Objective to investigate the imaging features of complications after hip arthroplasty. Methods 28 patients (31 times) with complications after hip arthroplasty and underwent revision hip arthroplasty were analyzed retrospectively and their imaging findings were observed. Results of 31 cases, 4 cases were diagnosed as dislocation of the femoral head after operation. X-ray plain film showed that the femoral head was located outside the acetabulum. In 22 cases of aseptic loosening, X-ray showed the clear band of 2~30mm around the prosthesis. Among them, the CT/MRI of chronic granulomatous inflammation around the prosthesis showed bony destruction and soft tissue mass. In 4 cases of infection, X-ray showed that the contour of 2~4mm around the prosthesis was not consistent with the shape of the prosthesis, and the MRI showed swelling of soft tissue in the infected area. One case of ectopic ossification, X-ray showed a large number of soft tissue ossification around the acetabular prosthesis. Conclusion the clear zone around prosthesis is the most important X-ray manifestation of joint loosening after artificial hip arthroplasty. CT/MRI is helpful to distinguish chronic granulomatous inflammation of prosthesis in aseptic loosening in order to distinguish infection from aseptic loosening.
【作者单位】：暨南大学附属第一医院影像中心;暨南大学附属第一医院骨科;
【分类号】：R687.4;R816.8

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