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Diagnostic Value of Magnetic Resonance (MR) Combined with Computed Tomography (CT) in Patients with Stress Injury of Femoral Neck

Jing Chen, Shaowei Zheng, Qingwei Song, Ailian Liu

Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)

Med Sci Monit 2020; 26:e922170

DOI: 10.12659/MSM.922170

Available online: 2020-07-03

Published: 2020-09-05

BACKGROUND: The purpose of this research was to study and analyze the diagnostic value of magnetic resonance (MR) combined with computed tomography (CT) in patients with stress injury of the femoral neck.
MATERIAL AND METHODS: The 58 patients with stress injury of the femoral neck who were treated in our hospital from July 2017 until July 2019 were selected as subjects on the basis of clinical pathology and surgery, MR and CT examination, and related imaging data retrospectively analyzed. We observed all patients using different diagnostic methods to determine the value of diagnosis and treatment of disease.
RESULTS: The patients selected for this study were confirmed by clinicopathology and surgery; the positive rate of CT diagnosis was 65.5%, the positive rate of MR diagnosis was 74.1%, and the positive rate of combined diagnosis was 91.4%. Through statistical analysis, CT and MR showed no significant difference in the detection of stress lesions in different femoral necks, indicating no statistical significance (P>0.05). However, the amount of stress lesions detected in the combined diagnosis was higher than that in the two separate detection methods, with statistically significant difference (P<0.05). The grading of stress lesions in all patients examined through MR showed that there was no proportion of grade 0, whereas grades 3-4 were the highest, accounting for 20.7% and 32.8% respectively. In CT scanning of all patients, fracture lines were observed in 35 patients, of which 25 were transparent lines and 10 were strip dense shadows; Periosteal reaction was observed in 34 patients, of whom umbilical concave was observed in 18 patients. Osteoporosis was observed in 30 patients, and the lesion showed a zone of reduced density in the cortical bone, with a stripelike shape and unclear boundary. The density tended to increase in the cavum medullare of 32 patients, with porosis being visible. Compared with CT diagnosis, the accuracy, sensitivity, and specificity of MR detection were not significantly different (P>0.05). The accuracy, sensitivity, and specificity of the combined detection were higher than that of CT and MR detection alone, with statistically significant differences between groups (P<0.05).
CONCLUSIONS: The application of MR combined with CT in early clinical diagnosis and treatment of femoral neck stress injury will improve the diagnosis rate; the imaging signal is obvious, which is helpful to further evaluate the severity of disease.

Keywords: Dental Stress Analysis, Stress Disorders, Traumatic, Acute, Urinary Incontinence, Stress