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Chinese Journal of Medical Ultrasound (Electronic Edition) >

2021 , Vol. 18 >Issue 03: 301 - 306

DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2021.03.011

Musculoskeletal Ultrasound

Application value of contrast-enhanced ultrasound in evaluating blood perfusion with osteonecrosis of the femoral head

  • Jin Yan ,
  • Qiushi Wei ,
  • Yuanyuan Tian ,
  • Shuai Zhao ,
  • Ping Zhao
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  • 1. Department of Ultrasound, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
    2. Department of Joint Orthopedics, the Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510240, China
Zhao Ping, Email:

Received date: 2020-06-29

  Online published: 2021-04-23

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Abstract

Objective

To evaluate the application value of contrast-enhanced ultrasound (CEUS) in evaluating blood perfusion of subchondral bone in patients with osteonecrosis of the femoral head.

Methods

Forty-eight patients (80 hips) with osteonecrosis of the femoral head at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March to September 2019 were collected. There were 65 hips with osteonecrosis of the femoral head, of which 31 hips were at ARCO stage II (stage II group) and 34 hips were at ARCO stage III (stage III group), and 15 normal hips (control group) by the staging criteria of the Association Research Circulation Osseous (ARCO). All subjects underwent ultrasound and CEUS examinations, and parameters including time to peak (TTP), peak intensity (PI), mean transit time (MTT), ascending slope (AS), and descending slope (DS) were quantitatively analyzed among the three groups. One-way ANOVA was used for comparing the PI and MTT of the three groups, and the LSD test was used for pairwise comparisons. The rank sum test was used for comparisons of TTP, AS, and DS among the three groups, and the Kruskal-Wallis test was used for pairwise comparisons. Taking MRI as the diagnostic gold standard, the operating characteristics (ROC) curves of the parameters were drawn to evaluate their performance for the diagnosis of femoral head necrosis.

Results

PI and AS values in the stage II group were significantly higher than those of the control group [(27.46±5.60) dB vs (21.06±5.37) dB, t=3.359, P=0.001; (1.69±0.78) vs 0.61(0.24, 0.88)], H=3.507, P=0.001], while MTT, TTP, and DS values in the stage II group were significantly lower than those of the control group [(51.99±16.63) s vs (68.65±17.46) s, t=3.336, P=0.001; 8.10 (7.32, 10.20) s vs 13.26 (10.36, 18.60) s, H=3.914, P＜0.001; (-0.18±0.09) vs (-0.08±0.05), H=3.608, P＜0.001]. PI and AS values in the stage III group were significantly higher than those of the control group [(31.79±6.70) dB vs (21.06±5.37) dB, t=5.713, P＜0.001; (2.4±1.00) vs 0.61 (0.24, 0.88), H=5.586, P＜0.001], while MTT, TTP, and DS values in the stage III group were significantly lower than those of the control group [(55.71±14.42) s vs (68.65±17.46) s, t=2.629, P=0.010; 7.81 (6.81, 9.25) vs 13.26 (10.36, 18.60) s, H=4.612, P＜0.001; (-0.22±0.09) vs (-0.08

±
0.05), H=4.818, P＜0.001]. PI and AS values in the stage II group were significantly lower than those of the stage III group [(27.46
±
5.60) dB vs (31.79
±
6.70) dB, t=2.876, P=0.005; (1.69
±
0.78) vs (2.40±1.00), H=2.532, P=0.034], but there was no significant difference in MTT, TTP, or DS between the two groups (P＞0.05). ROC curve analysis showed the AUC values of PI and AS were 0.848 (P＜0.001) and 0.916 (P＜0.001), respectively.

Conclusion

Contrast-enhanced ultrasound may be used as an effective supplement for the assessment of the blood perfusion of subchondral bone in patients with ARCO stage II and III osteonecrosis of the femoral head and can provide effective evidence for the diagnosis of osteonecrosis of the femoral head.

Key words： Contrast-enhanced ultrasound; Osteonecrosis of the femoral head; Time-intensity curve; Blood perfusion

Cite this article

Jin Yan , Qiushi Wei , Yuanyuan Tian , Shuai Zhao , Ping Zhao . Application value of contrast-enhanced ultrasound in evaluating blood perfusion with osteonecrosis of the femoral head[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021 , 18(03) : 301 -306 . DOI: 10.3877/cma.j.issn.1672-6448.2021.03.011

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