MRI在外伤性椎体压缩骨折时间推断中的应用  

The value of MRI in inferring the injury time of traumatic vertebral compression fracture

作　　者：聂素林[1] 郭新全[2] 孙世杭[1] 王滨[1] 董鹏[1] 孙西河[1] 

机构地区：[1]潍坊医学院医学影像学系,山东潍坊261653 [2]潍坊医学院附属医院影像中心,山东潍坊261031

出　　处：《医学影像学杂志》2011年第1期107-111,共5页Journal of Medical Imaging

摘　　要：目的:通过椎体压缩骨折外伤时间与MRI表现的相关性研究,探讨MRI在推断外伤性椎体压缩骨折时间中的应用价值。方法:回顾性分析外伤性椎体压缩骨折88例,按照外伤后MRI检查的时间分为7组。分析骨折时间与压缩程度、T1WI及T2STIR序列上病变椎体与正常椎体的信号强度比、骨髓水肿面积等的相关关系,并以骨折时间为应变量(y),压缩程度(x1)、T1WI、T2STIR信号强度比(x2、x3)、骨髓水肿面积(x4)为自变量进行逐步回归分析,求出多元线性回归模型。结果:随着时间推移,同一椎体压缩骨折有程度加重的趋势(r=0.177,P=0.047);T1WI-SIR有升高的趋势(r=0.070,P=0.436),但组间无统计学显著性差异(F=1.985,P=0.73);T2STIR-SIR呈下降趋势,与骨折时间呈负相关(r=-0.277,P=0.04);骨髓水肿面积有缩小的趋势,与骨折时间呈负相关(r=-0.410,P=0.00)。以骨折时间为应变量进行逐步回归分析,椎体压缩程度(x1)与骨髓水肿面积(x4)两个变量具有统计学意义(P=0.00)。结论:MRI可以反映外伤性椎体压缩骨折的愈合过程,并可用于骨折时间的推断。Objective：To study the value of magnetic resonance imaging（MRI） in inferring the injury time of vertebral compression fracture.Methods：88 patients proved traumatic vertebral compression fractures were retrospectively analyzed.The patients were divided into 7 groups according to injury time.The correlation between the injury time and the degree of vertebral compression,the signal intensity,the area of bone marrow edema were analyzed.Then multiple variables stepwise regression analysis was performed.The injury time was as dependent variable（y）,the degree of compression,T1WI and T2STIR signal intensity ratio compare with normal vertebrae,the area of marrow edema were as independent variables（x1,x2,x3,x4）.A multiple linear regression model was derived.Results：With the fracture time growing,the compression degree of the same vertebra was gradually increasing（r=0.177,P=0.047）.Also increasing trend was shown in the T1WI-SIR（r=0.070,P=0.436）.There was decreasing trend in the T2 STIR-SIR and was negatively correlated to the injury time（r=-0.277,P=0.04）.So it was the area of marrow edema（r=-0.410,P=0.000）.There were significant difference in the degree of vertebral compression（x1） and the area of marrow edema（x4）on the multiple variables stepwise regression analysis（P=0.000）.Conclusion：MRI may reflect the traumatic vertebral compression fracture healing process,which can be used to infer the injury time.

关 键 词：椎体压缩骨折 磁共振成像 外伤时间推断 

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