血清胆碱乙酰转移酶联合DCE-MRI参数对股骨颈骨折患者术后股骨头坏死的预测价值

doi:10.3969/j.issn.1009-976X.2025.03.006

摘要/Abstract

摘要： 目的分析血清胆碱乙酰转移酶（ChAT）联合动态对比增强磁共振成像（DCE-MRI）参数对股骨颈骨折患者术后股骨头坏死的预测价值。方法选取2020年1月至2023年6月期间河南省洛阳正骨医院洛阳院区收治的120例股骨颈骨折患者作为研究对象,根据术后是否发生股骨头坏死分为发生组和未发生组,均接受DCE-MRI检查,比较两组相关检查参数与血清ChAT水平,并采用受试者工作特征（ROC）曲线分析血清ChAT与DCE-MRI参数对股骨颈骨折预后情况的预测价值。结果发生组血清ChAT水平低于未发生组,容量转移常数（K^trans）、速率常数（K_ep）和初始时间-浓度曲线下面积（iAUC）值均高于未发生组（P<0.05）;血清ChAT、DCE-MRI参数及联合检查的曲线下面积（AUC）值范围为0.765~0.962,且灵敏度与特异度较高。结论血清ChAT联合DCE-MRI参数对股骨颈骨折患者术后发生股骨头坏死具有一定预测价值,采用联合检查方案有望为临床选择治疗方式提供依据。

关键词: 胆碱乙酰转移酶, 动态对比增强磁共振成像, 股骨颈骨折, 股骨头坏死

Abstract: Objective To analyze the predictive value of serum choline acetyltransferase（ChAT） combined with dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） parameters for postoperative femoral head necrosis in patients with femoral neck fractures. Method 120 patients with femoral neck fractures who underwent surgery at Luoyang Orthopedic Hospital Luoyang district, Henan Province from January 2020 to June 2023 were selected as the research subjects.They were divided into an occurrence group and a non-occurrence group based on whether they developed femoral head necrosis after surgery. Both groups underwent DCE-MRI examination, and the relevant examination parameters and serum ChAT levels were compared between the two groups. The receiver operating characteristic（ROC） curve was used to analyze the value of serum ChAT and DCE-MRI parameters in the prognosis of femoral neck fractures. Results The serum ChAT level in the occurrence group was lower than that in the non-occurrence group, and the volume transfer constant（K^trans）, rate constant（K_ep）, and area under the initial time concentration curve（iAUC） values were all higher than those in the non-occurrence group（P<0.05）. The range of serum ChAT, DCE-MRI parameters, and area under the curve（AUC） values for combined examination was 0.765~0.962, indicating high sensitivity and specificity. Conclusion The combination of serum ChAT and DCE-MRI parameters has certain predictive value for postoperative femoral head necrosis in patients with femoral neck fractures. The use of a combined examination plan is expected to provide a basis for clinical treatment selection.

Key words: choline acetyltransferase, dynamic contrast-enhanced magnetic resonance imaging, femoral neck fracture, femoral head necrosis

中图分类号:

R683.42

李德, 陈武林, 孙瑞波, 刘又文. 血清胆碱乙酰转移酶联合DCE-MRI参数对股骨颈骨折患者术后股骨头坏死的预测价值[J]. 岭南现代临床外科, 2025, 25(03): 179-183.

LI De, CHEN Wu-lin, SUN Rui-bo, LIU You-wen. The predictive value of serum choline acetyltransferase combined with DCE-MRI parameters for postoperative femoral head necrosis in patients with femoral neck fractures[J]. Lingnan Modern Clinics In Surgery, 2025, 25(03): 179-183.

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