骨质疏松和溶骨性转移瘤所致脊柱压缩骨折的影像方法选择  

Selection of imaging methods for spinal compression fractures caused by osteoporosis and osteolytic metastases

作　　者：王占国 Wang Zhanguo(Traditional Chinese Medicine Traumatology Hospital of Zhuzhou City,Hunan Zhuzhou 412000)

机构地区：[1]株洲市中医伤科医院,湖南株洲412000

出　　处：《中国社区医师》2021年第8期114-115,共2页Chinese Community Doctors

摘　　要：目的:评估X线、CT及MRI诊断骨质疏松和溶骨性转移瘤所致脊柱压缩骨折的影像学结果。方法:2018年4月-2020年6月医院诊断的椎体压缩性骨折患者100例,其中骨质疏松患者50例纳入试验1组;溶骨性转移瘤患者50例纳入试验2组。两组均予以X线、CT及MRI诊断,统计影像学诊断结果。结果:试验1组中,CT诊断的骨折线检出率高于X线、MRI诊断,差异有统计学意义(P<0.05);CT诊断及MRI诊断的附件骨折检出率及椎管狭窄检出率均高于X线诊断,差异有统计学意义(P<0.05)。试验2组中,CT诊断及MRI诊断的骨质破坏检出率均高于X线诊断,差异有统计学意义(P<0.05);CT及MRI诊断的附件受累检出率、椎管狭窄检出率及软组织肿块检出率均高于X线诊断,差异有统计学意义(P<0.05);CT诊断的骨质疏松检出率高于X线诊断,差异有统计学意义(P<0.05)。结论:为脊柱压缩骨折实施X线诊断,有助于明确进一步检测方式。针对存在骨质疏松的患者多建议实施CT诊断;针对不存在骨质疏松、存在恶性肿瘤疾病病史或是存在神经方面挤压情况的患者,建议实施MRI诊断。Objective:To evaluate the imaging results of X line,CT and MRI in the diagnosis of spinal compression fractures caused by osteoporosis and osteolytic metastases.Methods:From April 2018 to June 2020,100 cases of patients with vertebral compression fracture who were diagnosed in our hospital were enrolled,50 patients with osteoporosis were enrolled in No.1 experimental group,50 patients with osteolytic metastases were enrolled in No.2 experimental group.X line,CT and MRI diagnosis were performed in both groups,imaging diagnosis results was counted.Results:In No.1 experimental group,the detection rate of fracture line by CT was higher than that by X line and MRI,the difference was statistically significant(P<0.05).The detection rates of accessory fracture and spinal stenosis by CT and MRI were higher than those by X line,the differences were statistically significant(P<0.05).In No.2 experimental group,the detection rate of bone destruction by CT and MRI was higher than that by X line,the difference was statistically significant(P<0.05).The detection rates of accessory involvement,spinal stenosis and soft tissue mass by CT and MRI were higher than those by X line,the differences were statistically significant(P<0.05).The detection rate of osteoporosis by CT was higher than that by X line,the difference was statistically significant(P<0.05).Conclusion:X line in the diagnosis of spinal compression fracture is helpful for further detection.CT diagnosis is recommended for patients with osteoporosis,MRI diagnosis is recommended for patients who do not have osteoporosis,but have a history of malignant tumor disease or have nerve extrusion.

关 键 词：骨质疏松 溶骨性转移瘤 脊柱压缩骨折 X线 CT MRI 

分 类 号：R580[医药卫生—内分泌] R738.1[医药卫生—内科学]