脊椎转移瘤及单纯椎体骨折的低场磁共振鉴别诊断及扫描技术探讨  

Low field magnetic resonance imaging technology and differential diagnosis of spinal metastases and pure vertebral fracture

作　　者：赵明范 李桂英[2] 

机构地区：[1]大兴安岭职业学院,黑龙江加格达奇165000 [2]北京老年医院放射科

出　　处：《中国伤残医学》2017年第16期13-15,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：比较脊椎转移瘤所致椎体骨折与单纯椎体骨折的低场MRI诊断价值,并探讨各扫描序列的应用价值.方法：对比分析257例（共399个椎体）脊椎转移瘤及151例（共223个椎体）椎体单纯骨折的低场MRI特点,应用二值多元Logistic回归,分析椎体形态、病变信号、椎弓根、椎间盘、椎旁软组织肿物等在脊椎转移瘤和椎体单纯骨折中的变化,及其在低场MRI不同扫描序列的表现.结果：T2加权水脂分离序列（WFS序列及STIR序列）对椎体转移瘤及急性和亚急性单纯椎体骨折的敏感性高于其他扫描序列,脊椎转移瘤不累及椎间盘,椎体单纯骨折可累及椎间盘.结论：应用低场MRI可准确诊断椎体转移瘤或单纯椎体骨折.扫描时应首选T2加权水脂分离序列（WFS或STIR序列）,结合T1WI及T1增强序列,根据病灶信号特点,结合椎体形状、椎弓根改变及椎旁软组织等可作出准确诊断.Objective： To compare the diagnostic value of low field magnetic resonance imaging （MRI） in spine vertebral fractures caused by metastases with pure vertebral fractures, and discuss different scanning sequence application value. Materials and Methods： The comparative analysis of MR imaging characteristics in 257 cases （399 vertebrae were） spinal metastases and 151 cases （223 pure ver- tebral fractures of vertebral） was done in this study. The Logistic regression analysis was used in the study of vertebral body shape, signal, pedicle and disc changes, paraspinal soft tissue masses in the vertebral metastases and pure vertebral fractures, and their different per- formanee in different low field MRI sequences were analyzed. Results： T2 - weighted sequence of water fat separation （ WFS sequences and STIR sequence） in the demonstration of the vertebral metastases and pure acute and subacute vertebral fractures was more sensitive than other sequences. Spinal metastases did not involve the intervertebral disc. Pure vertebral fractures may involve the disc. Conclusion： Low field MRI can accurately diagnose vertebral metastases or vertebral fracture, according to the signal characteristics of lesions, verte- bral body shape and pedicle changes, and paraspinal soft tissue. T2 - weighted water fat separation imaging sequence （WFS or STIR sequences） should be the first choice, and combined with T1WI and enhanced T1WI sequence.

关 键 词：椎体 转移瘤 单纯骨折 MRI表现 

分 类 号：R445.2[医药卫生—影像医学与核医学]