目的 分析放射性核素骨显像 (Single photon emission computed tomography, SPECT)与核磁共振扫描 (magnetic resonance imaging, MRI) 对早期股骨头缺血坏死 ( A v a s c u l a r Necrosis of Femoral Head, ANFH)的诊 断价值。方法 收集2014年5月-2017年6月 于我院拟诊为早期ANFH的患者共88例设为 研究对象，将其SPECT与MRI诊断结果与 临床确诊结论对照，比较SPECT与MRI诊 断早期ANFH的临床价值。结果 88例患者 确诊早期ANFH 62例，类风湿性关节炎12 例，暂时性骨质疏松7例，股骨头内软骨 母细胞瘤1例，色素沉着绒毛结节性骨膜 炎6例；SPECT诊断早期ANFH的敏感度、 特异度、准确率、阳性预测值、阴性预 测值、kappa值分别为98.38%、88.46%、 95.45%、95.31%、95.83%、0.888，高 于MRI的93.51%、50.00%、80.68%、 84.69%、76.47%、0.484，且特异度、准 确率、阴性预测值比较差异有统计学意义 (P＜0.05)。结论 SPECT与MRI在诊断早期 ANFH上均具有较高的特异度、准确率及阴 性预测值，值得临床推广。

Objective To analyze the value of single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) in the diagnosis of early avascular necrosis of femoral head (ANFH). Methods A total of eighty-eight patients with early ANFH who were admitted to the hospital during the period from May 2014 to June 2017 were enrolled in the study. The results of SPECT and MRI diagnosis were compared with the clinical diagnosis. The clinical value of SPECT and MRI in diagnosis of early ANFH was compared. Results Among 88 patients, 62 cases were diagnosed as early ANFH, 12 cases were rheumatoid arthritis, 7 cases were temporary osteoporosis, 1 case was chondroblastoma in femoral head and 6 cases were pigmented villonodular nodular periostitis. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of PECT in diagnosis of early ANFH (98.38%, 88.46%, 95.45%, 95.31%, 95.83% and 0.888) were higher than those of MRI (93.51%, 50.00%, 80.68%, 84.69%, 76.47% and 0.484), with statistically significant differences in specificity, accuracy and negative predictive value (P<0.05). Conclusion Both of SPECT and MRI had high specificity, accuracy and negative predictive value in the diagnosis of early ANFH, and it is worthy of clinical application.