磁共振表观扩散系数定量测量对脊柱良恶性压缩骨折的鉴别诊断  

Evaluation of MR quantitative ADC in discriminating benign and malignant compression fracture of vertebrae

作　　者：周宙[1] 刘志兰[1] 苏丹[1] 

机构地区：[1]哈尔滨医科大学附属第一临床医学院磁共振科,黑龙江哈尔滨150001

出　　处：《中国临床医学影像杂志》2008年第5期346-349,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨应用磁共振扩散加权成像(DWI)在椎体良恶性压缩骨折中的鉴别诊断价值。方法:共51例脊柱椎体压缩性骨折行MRI平扫和扩散加权序列检查,其中47例行X线检查,42例行CT检查。良性组24例椎体,其中包括单纯外伤所致11例,骨质疏松13例,恶性组27例椎体,包括转移瘤21例,多发骨髓瘤1例,非何杰金淋巴瘤1例,结核4例。正常对照组51个椎体。b值为300s/mm2,分析良恶性病变椎体及正常椎体DWI信号特点,并测定ADC值,定量分析比较良恶性病变组与对照组之间ADC值有无统计学差异。结果:良性压缩性骨折与恶性压缩性骨折DWI信号经统计分析,P>0.05无统计学差异;良性组ADC值为(2.14±0.75)×10-3mm2/s,恶性组ADC值为(1.27±0.42)×10-3mm2/s,对照组ADC值为(0.68±0.21)×10-3mm2/s,病变组ADC值均明显高于对照组(P<0.05),良性组明显高于恶性组(P<0.05)。结论:磁共振ADC值定量测量对脊柱良恶性压缩骨折具有重要的鉴别诊断价值;DWI信号变化不能准确的鉴别脊柱良恶性压缩骨折。Objective： To evaluate diffusion-weighted MRI in discriminating vertebral benign and malignant compression fracture. Methods： Both conventional MR and diffuslon-weighted MRI were performed in 51 patients with vertebral fractures, X-ray examination were performed in 47 cases, CT scanning were performed in 42 cases, of which 24 were benign fractures （11 traumatic and 13 osteoporotic）, 27 were malignant compression fractures, including metastases （n=21）, myeloma （n=1）, non- Hodgkin＇s lymphoma（n=1）, tuberculosis（n=4）, 51 cases were normal vertebral body group（n=51）. 300s/mm^2 was taken as b value. Signal intensities on DWI were compared and apparent diffusion coefficient （ADC） values were calculated. ADC values among the benign and malignant were quantitatively analyzed and compared. Result： The ADC value in benign fracture was （2.14±0.75）×10^-3mm^2/s, the ADC value in malignant fracture was （1.27±0.42）×10^-3mm^2/s. The ADC value in normal vertebral body group was （0.68±0.21）×10^-3mm^2/s. The ADC value of the abnormal groups was higher than that of the normal group （P〈 0.05）, and benign group higher than that of the malignant group （P〈0.05）. Data analysis revealed that no significant difference existed between benign fracture and malignant fracture（P〉0.05）. Conclusion： MR quantitative ADC measurement have important discrimination value to differentiating the benign and malignant fractures. Signal intensity of diffusion-weighted MRI can not accurately distinguish benign and malignant fractures.

关 键 词：脊柱骨折 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]