目的 探讨不同MRI分期股骨头坏死(FHN)的放射性核素骨显像(RBI)征象及其与MRI的分期关系.方法 分析42例(72髋)经临床随访和病理证实的FHN患者的影像学资料,包括同期进行的RBI和MR检查,依据MRI不同表现分期后对RBI征象进行分析.结果 72髋FHN中,23髋MRI上股骨头外形正常、坏死区呈单纯脂肪样信号(Ⅰ期),RBI上11髋呈“手托白球征”、7髋呈“炸面圈征”；37髋MRI上股骨头外形正常、坏死区呈脂肪肉芽组织样混合信号(Ⅱ期),RB1可见4髋呈“手托白球征”、7髋呈“手托黑球征”、7髋“炸面圈征”和16髋弥漫性浓集；12髋MRI上股骨头塌陷但未见骨性关节炎征象(Ⅲ期),RBI上10髋呈弥漫性浓集.结论 不同MRI时期FHN的RBI表现多样,其中“手托白球征”、“手托黑球征”和“炸面圈征”具有特征性,而弥漫性浓集常出现于Ⅱ期和Ⅲ期FHN.%Objective To explore the manifestations of femoral head necrosis (FHN) in different MRI stages on radionuclide bone imaging (RBI). Methods The imaging data including RBI and MR examination of 42 patients (72 hips) with FHN confirmed with clinical follow-up or pathology were collected. Analysis of RBI signs was done on the basis of different MRI stages. Results Of 72 hips on MRI, 23 hips with pure fat signal in necrotic zone were regarded as stage I , among which 11 hips showed "hand holding white ball sign" and 7 hips showed "donut sign" on RBI. Thirty-seven hips with fat-granulation tissue mixed signal in necrotic zone were regarded as stageⅡ,among which 4 hips showed "hand holding white ball sign" . 7 hips showed "hand holding black ball sign" , 7 showed "donut sign" and 16 showed diffusely increased uptake on RBI. Twevle hips with head collapse on MRI were regarded as stage Ⅲ , RBI showed diffusely increased uptake for 10 hips. Conclusion There are several different RBI manifestations of FHN in different MRI stages, of which the "hand holding white ball sign" , "hand holding black ball sign" and "donut sign" have diagnostic value, while the diffusely increase uptake often seen in the stage Ⅱ and Ⅲ of FHN.
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