X线、CT、MRI在评估症状性骨质疏松椎体压缩骨折手术治疗中的价值  

Imaging assessing symptomatic vertebral compression fracture to be treated by vertebroplasty and kyphoplasty in osteoporosis patients

作　　者：徐妍妍[1] 李斌[1] 邹海波[2] 绳厚福[2] 王武[1] 孙宏亮[1] 

机构地区：[1]中日友好医院放射诊断科,北京100029 [2]中日友好医院脊柱外科,北京100029

出　　处：《中华医学杂志》2014年第11期832-835,共4页National Medical Journal of China

摘　　要：目的 探讨X线、CT、MRI在评估症状性骨质疏松椎体压缩性骨折手术治疗中价值.方法 回顾性分析北京中日友好医院2011年11月至2012年5月41例经皮椎体成形术（PVP）及经皮球囊扩张椎体后凸成形术（BKP）单纯骨质疏松椎体压缩性骨折患者的术前胸腰椎CT（含三维重建）、MRI（含脂肪抑制序列）及手术前后X线影像学资料.结果 在CT扫描中共显示52个病变椎体,而在MRI共显示70个病变椎体,其中新发骨折44个,陈旧骨折8个,骨挫伤18个,其中8个陈旧骨折和2个挫伤的椎体程度较轻采取保守治疗,结合MRI检查序列特别是脂肪抑制序列显示60个有治疗意义椎体,效果优于CT检查;胸腰椎X线显示60个病变椎体术后高度有所提高,Cobb角略减小,椎体局部后凸情况有所改善,有助于手术疗效评估及术后追随.结论 术前CT、MRI对单纯骨质疏松椎体压缩性骨折手术治疗具有重要临床指导意义,能够对治疗提供术前参考,提高治疗准确性及疗效.X线检查有助于术后疗效评估及术后追随.Objective To evaluate the values of radiology, computed tomography （CT） and magnetic resonance imaging （MRI） in assessing symptomatic osteoporosis vertebral compression fractures in vertebroplasty and kyphoplasty. Methods Retrospective reviews were conducted for 41 osteoporotie vertebral compression fractures patients with preoperative CT （with 3D reeonstruction）/MRI （with fat saturation sequence） and preoperative and postoperative radiological imaging data. All patients underwent pereutaneous vertebroplasty （PVP） or balloon kyphoplasty （BKP） when conservative treatment failed to offer pain relief. Results CT scan showed 52 vertebral fractures while MRI detected a total of 70 lesions of vertebral body, including 44 new fractures, 8 old fractures and 18 bone bruises. Eight old fractures and 2 mild bone bruises were treated conservatively. In conjunctions with MRI, especially fat saturation sequence, 60 therapeutic vertebral bodies were visualized. It was superior to CT. As demonstrated by preoperative and postoperative radiology, vertebral body height improved and Cobb Angle slightly decreased for 60 lesions. Conclusion For vertebral compression fractures in osteoporosis patients, preoperative CT and MRI examinations have important clinical significance in providing treatment guidance and assessing postoperative outcomes.

关 键 词：磁共振成像 骨质疏松性骨折 骨折 压缩性 

分 类 号：R687.3[医药卫生—骨科学]