MR多种成像技术在脊柱压缩骨折病因研究中的应用  

Multiple MRI techniques in the diagnosis and differentiation of benign and pathologic vertebral compression fracture

作　　者：张铎[1] 孟恒[1] 

机构地区：[1]北华大学附属医院CT,MRI科,吉林吉林132011

出　　处：《中国临床医学影像杂志》2006年第10期584-587,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MR多种成像技术对脊柱压缩骨折病因的诊断价值。材料和方法:48例(共88个椎体)脊柱椎体压缩行MR平扫T1、T2及T2脂肪抑制,DWI及T1增强扫描。其中病理性骨折28例(55个椎体,包括转移性肿瘤24例、骨髓瘤1例、结核4例);单纯性骨折20例33个椎体,包括单纯外伤所致14例,骨质疏松6例。病理性骨折者,经穿刺检查或手术病理证实,部分临床证实;外伤或骨质疏松所致椎体压缩骨折均符合临床、实验室检查及MRI表现,部分随访证实。结果:单纯性骨折20例共33个椎体,T2WI呈高、混杂信号27个,低、等信号6个,DWI呈高、混杂信号5个,低、等信号28个。病理性骨折28例共55个椎体,T2WI呈高、混杂信号42个,低、等信号13个,DWI呈高、混杂信号51个,低、等信号4个,T1+T2组合确诊数为82.3%,多种组合T1+T2+T1增强+T2抑脂+DWI,确诊数为98.6%。结论:MR多种成像技术联合应用对单纯性骨折和病理性骨折的鉴别可提供很大帮助。Objective： To study multiple MRI techniques in the differentiation of benign and pathologic vertebral compression fracture. Methods： Forty-eight vertebral fracture（88 vertebrae） patients, including 28 pathologic compression fractures（55 vertebrae including 24 metastasis, 1 myeloma, 4 tuberculosis） and 20 benign fracture（33 vertebrae including 14 traumatic and 7 osteoporotic fractures）, were examined with conventional MR（T1WI, T2WI, STIR, DWI and enhanced T1WI）. Pathological fracture was proven by biopsy or surgery and benign compression fracture were proven by clinical manifestation, MRI and follow-up. Results： There were 20 benign fracture（33 vertebrae）. Compared with the adjacent normal vertebrae, in the benign vertebral compression fracture 27 showed hyper- or mix-intensity signal and 6 hypo- or iso-intensity signal on T2WI. On DWI, 5 showed hyper- or mix-intensity signal and 28 hypo- or iso-intensity signal. There were 28 pathologic compression fracture（55 vertebrae）. Compared with the adjacent normal vertebrae, in the malignant vertebral compression fracture 42 showed hyper- or mix-intensity signal and 13 hypo- or iso-intensity signal on T2WI. On DWI, 51 showed hyper- or mix-intensity signal and 4 showed hypo- or iso-intensity signal. The total diagnostic accuracy with T1＋T2 MRI sequences combined was 82.3%, with T1＋ T2＋enhanced T1WI＋STIR＋DWI MRI sequences was 98.6%. Conclusion： The combined use of the multiple MRI sequences is very helpful in differentiation of benign and pathologic vertebral compression fracture.

关 键 词：脊柱骨折 磁共振成像 

分 类 号：R683.2[医药卫生—骨科学] R445.2[医药卫生—外科学]