| Objiective1.Comparing the difference of the hemodynamic parameters of the femoral artery between the ONFH(osteonecrosis of the femoral head)group and the control group with conventional ultrasound,and discussing the changes of blood flow perfusion of femoral head in patients with ONFH through the analysis of different indexes.2.On the basis of previous studies,CEUS was used to compare the ultrasound contrast parameters of femoral head between ONFH group and control group.And then evaluating the value of the femoral head blood flow perfusion in patients with ONFH by analyzing the difference of contrast index.3.Through analyzing the difference of the contrast parameters of femoral head of patients who were on the stageⅡand stage Ⅲ in ONFH group,to reserach the difference of the femoral head blood perfusion among patients with ONFH at different stages.Method:1.There were 60 femoral heads in 37 patients of ONFH group and 20 femoral heads in 10 patients of control group,and all of them received routine ultrasound examination.The blood flow parameters(D、PSV and RI)of medial femoral circumflex artery were recorded and the difference of each parameter in two groups was compared.2.On the basis of the previous study,all the patients in ONFH group and the healthy volunteers in control group included in the study were examined by contrast-enhanced ultrasound,and the differences between the two groups were observed by the method of inter-group control.Then,the difference of the parameters of femoral head contrast of patients in ONFH group between theⅡand stage Ⅲ was compared,and discussing the correlation between the parameters and stages.Results:1.Through the comparison the results of color Doppler ultrasound examination between ONFH group and control group: it was found that there was no significant difference of age,PSV and RI between ONFH group and control group(p > 0.05),while the internal diameter of medial femoral circumflex artery had significant difference(p < 0.01).2.The contrast examination time-intensity curve of femoral head between ONFH group and control group was analyzed.By comparing the difference,T1,T2,T3,RS1,RS2 and mTT between ONFH group and normal group showed significant difference(p < 0.01).3.The results of ultrasound contrast analysis of femoral head between patients at 2 and 3 stage in ONFH group: There was significant difference of T3(p < 0.01).The difference of RS2 and mTT was statistically significant(p < 0.05).The other parameters had no statistical significance(p > 0.05).There was significant negative correlation between T3 and the staging,the spearman correlation coefficient r =-0.77(p = 0.00);while there was a significant positive correlation between the RS2 and the staging,and the spearman correlation coefficient r = 0.77(p = 0.00).The mTT was negatively correlated with the staging,spearman correlation coefficient r =-0.73(p = 0.00).Conclusion:1.Contrast-enhanced ultrasound parameters,especially the attenuation slope of time-intensity curve and average transit time,have significant differences between the normal people and ONFH patients,and different stages of ONFH patients,while that have obvious correlation with the ARCO stage of ONFH patients.Therefore,the femoral head ultrasound angiography has high clinical application value.2.To a certain extent,contrast-enhanced ultrasound can reflect the distribution characteristics of femoral head microvascular.It is superior to common Doppler ultrasound on displaying and analyzing the blood supply of femoral head.And it is feasible to use conventional ultrasound contrast ONFH in the actual clinical application.3.Contrast-enhanced ultrasound(CEUS)can evaluate the characteristics of Microvascular in femoral head safely,noninvasively and visually,and it can measure the quantitative parameters of femoral head blood supply.Before and after the hip-preserving treatment,the parameters of contrast time-intensity curve may be of some value to the evaluation of curative effect. |
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