MRI、CT对良、恶性脊柱压缩骨折病因的鉴别诊断价值  

Clinical Value of MRI and CT in Diagnosing Benign and Malignant Vertebral Compression Fracture

作　　者：刘延华 李婧[2] 

机构地区：[1]山东省单县人民医院,山东单县274300 [2]山东省单县中心医院

出　　处：《中国医学创新》2016年第4期1-5,共5页Medical Innovation of China

摘　　要：目的:探讨MRI、CT对良、恶性脊柱压缩骨折病因的鉴别诊断价值。方法:选取本院2012年2月-2014年2月收治的脊柱压缩性骨折患者80例108个椎体作为研究对象,其中恶性压缩骨折34例48个椎体,良性骨质疏松性压缩骨折26例36个椎体,外伤性压缩骨折20例24个椎体,对其CT、MRI等临床资料进行回顾性分析。结果:恶性压缩骨折组中多倒楔形形态椎体,椎管软组织肿块影,椎弓根破坏,椎体后缘膨隆;良性压缩骨折组中多楔形形态椎体,椎体后缘多见成角。恶性压缩骨折组ADC值低于良性压缩骨折组,比较差异有统计学意义(P<0.01),CT诊断良性脊柱压缩骨折准确率髙于恶性骨折,比较差异有统计学意义(P<0.05)。良性压缩骨折组行MRI联合螺旋CT检查,骨质疏松性压缩骨折诊断符合率为92.31%,外伤性压缩骨折诊断符合率达到100%。恶性压缩骨折组行MRI联合螺旋CT检查诊断正确率位97.06%。结论:CT对良性脊柱压缩性骨折的患者的诊断具有较高的准确率,在恶性脊柱压缩骨折诊断中,MRI具有较高价值,联合MRI和CT用于脊柱压缩骨折患者病因的鉴定,具有重要的鉴别诊断意义。Objective： To investigate the clinical value of MRI and CT in diagnosing benign and malignant vertebral compression fracture.Method： 108 centrums in 80 patients with benign and malignant vertebral compression fracture in our hospital from February 2012 to February 2014 were selected as the research objects.48 centrums in 34 eases were malignant vertebral compression fracture, 36 centrums in 26 cases were osteoporotic compression fracture and 24 centrums in 20 cases were traumatic compression fracture.Their clinical data of CT and MRI were retrospectively analyzed.Result： In the malignant vertebral compression fracture group, most of the eentrums were pour the wedge, spinal canal had soft tissue mass, the pedicle damage was damaged and the vertebra posterior border was distention.In the benign compression fractures group, most of the centrums were wedge-shape and most of the vertebra posterior border was angulation.The value of ADC in the malignant vertebral compression fracture group was lower than that in the benign compression fracture group, the difference was statistically significant （ P〈O.01 ） .The accuracy rate of CT in the diagnosis of benign spinal compression fractures was higher than that in the diagnosis of malignant bone fracture, the difference was statistically significant （ P〈0.05 ） .Using the examination of MRI combined with CT, the diagnose accordance rate of osteoporosis-induced compression fracture was 92.31%, the diagnose accordance rate of traumatic compression fractures was 100% and the diagnose accordance rate of malignant vertebral compression fracture was 97.06%.Conclusion： The diagnosis accuracy rate of CT for patients with benign spinal compression fracture is high.In the diagnosis of malignant spinal compression fracture, MRI has high value.MRI combined with CT has an important significance in the differential diagnosis of the etiology of spinal compression fracture.

关 键 词：磁共振成像 螺旋CT 脊柱 压缩骨折 

分 类 号：R687.3[医药卫生—骨科学]