Relationship between anterior or posterior femoral head necrosis and collapse based on MRI-defined key necrotic layer sets.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-03-07 DOI:10.1186/s13018-025-05633-2

Yawei Dong, Yan Yan, Jun Zhou, Kaiqiang Tang, Xiaohan Wang, Rui Quan, Jiaming Lin, Yan Jia, Zelu Zheng, Baohong Mi, Weiheng Chen

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Abstract

Background: Current clinical studies on femoral head necrotic lesions primarily focus on the medial and lateral regions, while detailed MRI-based methods to evaluate the relationship between anterior or posterior necrosis and collapse remain lacking.

Objective: By defining the anterior and posterior positions of the femoral head in MRI, a method was proposed for rapid clinical prognosis assessment of femoral head necrosis based on necrotic location.

Metohd: A retrospective analysis was conducted on TSE sequence T1W1 coronal plane images from 200 cases of femoral head necrosis. The frequency of necrotic lesions appearing on each MRI layer was statistically analyzed to construct a high-frequency necrotic layer set. Among these cases, 100 hips were randomly selected, and the relationship between femoral head collapse at one-year follow-up and different high-frequency necrotic layer sets was analyzed to identify the key necrotic layer set. Based on this, the anterior and posterior regions of the femoral head were defined on MRI. The remaining 100 hips were used as a validation set to assess the impact of anterior or posterior necrosis of the femoral head, as defined by this method, on collapse.

Results: In this study, a total of eight high-frequency necrotic lesion layer sets (S1-S8) were constructed based on MRI data. Among them, S3 (L1 + L2 + L0 + L3) showed the strongest correlation with femoral head collapse, with an AUC of 0.662. Therefore, S3 was defined as the anterior side of the femoral head. Analysis of the validation set revealed that, using this method, the probability of femoral head collapse was 11.4 times higher when necrotic lesions appeared on the anterior side compared to the absence of necrosis on the anterior side.

Conclusion: In MRI, the anterior side of the femoral head corresponds to the S3 region, where necrosis increases the risk of collapse by 11.4 times.

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根据核磁共振成像定义的关键坏死层组，股骨头前部或后部坏死与塌陷之间的关系。

背景：目前对股骨头坏死病变的临床研究主要集中在内侧和外侧区域，而基于mri的评估股骨头前后坏死与塌陷关系的详细方法仍然缺乏。目的：通过MRI对股骨头前后位置的明确，提出一种基于坏死部位快速评估股骨头坏死临床预后的方法。方法：回顾性分析200例股骨头坏死患者的TSE序列T1W1冠状面图像。统计分析各MRI层出现坏死病灶的频率，构建高频坏死层集。其中随机选取100例髋关节，分析1年随访时股骨头塌陷与不同高频坏死层集的关系，确定关键坏死层集。在此基础上，在MRI上确定股骨头的前后区域。剩余的100个髋被用作验证组，以评估股骨头前或后坏死对塌陷的影响。结果：本研究基于MRI数据共构建了8个高频坏死病变层集（S1-S8）。其中S3 （L1 + L2 + L0 + L3）与股骨头塌陷相关性最强，AUC为0.662。因此，S3被定义为股骨头前部。对验证集的分析显示，使用该方法，当股骨头前部出现坏死病变时，股骨头塌陷的概率是前面没有坏死时的11.4倍。结论：在MRI上，股骨头前部对应于S3区，坏死使股骨头塌陷的风险增加11.4倍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.