低场MRI在鉴别脊柱转移瘤与骨质疏松压缩骨折中的作用  

The significance of low field MRI in differentiating spinal metastatic compression fractures from osteoporotic compression fractures

作　　者：刘利 

机构地区：[1]山西省大同市基建职工医院影像科,山西大同037006

出　　处：《实用医学影像杂志》2010年第2期105-108,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨椎体转移瘤与骨质疏松压缩性骨折的MRI特征及其对诊断与鉴别诊断的意义。方法 50例病理证实的椎体转移瘤及30例临床随访证实的骨质疏松压缩性骨折患者术前均经低场(0.35T)MRI平扫及Gd-DTPA增强扫描。全部MRI操作是采用T1与T2加权序列进行的。结果压缩椎体的信号对转移瘤与骨质疏松压缩性骨折的鉴别无特异性,但椎体内残留有正常骨髓信号者,多见于骨质疏松压缩性骨折,而压缩椎体后缘突出,椎管狭窄,椎弓受累,椎旁软组织肿块及增强后压缩椎体呈不均匀性强化多见于转移瘤。结论低场MRI对于椎体骨质疏松压缩骨折和转移瘤性骨折的鉴别具有重要的价值。Objective To determine the significance of low field MRI for differentiating spinal metastatic compression frectures from osteoporotic compression fractures. Methods Fifty patients with pathologically proved spinal metastatic compression fractures and thirty patients with clinically proved vertebral osteoporotic compression fractures undenwent low field （0.35T） MR imaging without and with Gd DTPA contrast-enhanced scans. All procedures were performed by using T1 and T2 weighted sequences. Results The signals of the compressed vertebral body in differentiating metastatic and osteoporotic compression fractures were not specific. However, residual normal bone marrow signals of the vertebral body were mostly found in osteoporotic compression fractures while expansive posterior border of the vertebral body, vertebral tube narrowing, vertebral arch involvement, paravertebral soft tissue mass, and heterogeneous enhancement of the vertebral body after contrast agent administration were mostly found in metastatic compression fractures. Conclusion Low field MRI has important significance in differentiating vertebral osteoporotic compression fractures from metastatic compression fractures.

关 键 词：脊柱 压缩骨折 骨质疏松 转移瘤 低场强磁共振成像 

分 类 号：R738[医药卫生—肿瘤] R683[医药卫生—临床医学] R445.2