目的 旨在探讨MRI扫描对成人 股骨头坏死的诊断价值。方法 收集我 院2014年7月至2016年5月收治的股骨头 坏死患者53例的临床资料、影像学资 料等，总结股骨头坏死在MRI中的图像 特点，比较CT、MRI扫描诊断股骨头坏 死的阳性率、灵敏度、特异度，并分 析CT、MRI扫描对不同时期股骨头坏死 的准确诊断率。结果 MRI诊断股骨头 坏死阳性率、灵敏度、特异度分别为 92.06%、90.47%、84.12%，明显优于CT 79.36%、73.01%、68.25%，差异具有统 计学意义(P<0.05)；MRI对Ⅰ-Ⅱ期股骨 头坏死的诊断准确率明显高于CT(90.90% vs 36.36%)，差异具有统计学意义 (P<0.05)；MRI扫描中，Ⅰ-Ⅱ期股骨头 坏死者多呈现病变侧股骨头骨髓信号不 均匀，横断面及冠状位T1WI提示病侧股 骨头形态塌陷，并见不规则斑片状长T1 信号，在冠状位T1WI上表现为明显“线 样征”。结论 MRI扫描诊断成人股骨头坏 死阳性率、灵敏度、特异度高， 可有效 提高早期诊断准确率，值得临床推广。

Objective To investigate the value of MRI in the diagnosis of adult osteonecrosis of the femoral head. Methods The clinical data and imaging data of 53 patients with femoral head necrosis admitted from July 2014 to May 2016 in our hospital were collected, and the MRI image features of osteonecrosis of the femoral head were summarized, compare the positive rate, sensitivity and specificity of CT and MRI in diagnosing femoral head necrosis and analyze the accurate diagnosis rate of femoral head necrosis at different stages by CT and MRI. Results The positive rate, sensitivity and specificity of MRI in diagnosing femoral head necrosis were 92.06%, 90.47% and 84.12%, which were obviously higher than those of CT, 79.36%, 73.01% and 68.25%, the difference was statistically significant(P<0.05). MRI images show that stage I to stage II necrosis of the femoral head presents uneven bone marrow signal inhomogeneity in the diseased side of the femoral head, irregular flaky T1 signal was shown in the femoral head, and a small amount of long T1 signal is found in the joint cavity of a few patients, the coronal T1WI showed marked "line sign". Conclusion The positive rate, sensitivity and specificity of MRI scan in the diagnosis of adult femoral head necrosis are high, which can effectively improve the accuracy of early diagnosis, and is worthy of clinical promotion.