Abstract: This paper analyzed the diagnostic value of magnetic resonance imaging (MRI) combined with β-C-terminal cross-linking telopeptide of type 1 collagen (β-CTX) and plasminogen activator inhibitor-1 (PAI-1) in the diagnosis of femoral head necrosis. A total of 112 patients with suspected femoral head necrosis were selected as the research objects. According to the operative pathological examination as the "gold standard", 80 cases diagnosed with femoral head necrosis were set as the research group,32 cases of non-femoral head necrosis were set as the control group. MRI examination was performed in both groups, and the levels of β-CTX and PAI-1 in both groups were also examined. Compared with the control group, the first maximum reinforcement peak (fEmax) and the maximum reinforcement peak (Emax) in the study group were decreased, and the parameters of time to peak (TTP) were increased (P<0.05). In patients with femoral head necrosis stage Ⅰ-Ⅳ, the patients with stage Ⅳ necrosis of the femoral head, the levels of fEmax, Emax and β-CTX were the lowest, while the levels of TTP parameters and PAI-1 were the highest (P<0.05). fEmax, Emax, TTP, β-CTX and PAI-1 were correlated with different clinical stages (P＜0.05). Compared with the single diagnosis of fEmax (AUC=0.605), Emax (AUC=0.594), TTP (AUC=0.822), β-CTX (AUC=0.617), and PAI-1 (AUC=0.816), the five-item combination (AUC=0.831) had higher diagnostic value for femoral head necrosis (P<0.05). MRI combined with β-CTX and PAI-1 has high diagnostic value in the diagnosis and staging of femoral head necrosis.

Key words: femoral head necrosis, magnetic resonance imaging, β-C-terminal cross-linking telopeptide of type 1 collagen, plasminogen activator inhibitor-1