MRI在鉴别骨质疏松性椎体骨折及转移性肿瘤所致椎骨骨折中的应用价值分析  

Application Value of MRI in Differentiating Osteoporotic Vertebral Fractures from Vertebral Fractures Caused by Metastatic Tumors

作　　者：陈胜 毛渊青 CHEN Sheng;MAO Yuan-qing(Department of Orthopaedics,the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University,Suzhou 215228,Jiangsu Province,China)

机构地区：[1]南京医科大学附属江苏盛泽医院骨科,江苏苏州215228

出　　处：《中国CT和MRI杂志》2021年第12期160-162,共3页Chinese Journal of CT and MRI

基　　金：苏州市科技局民生科技关键技术应用研究(SS201850);吴江区卫计委“科教兴卫”项目(WWK201820);南京医科大学江苏康达医药卫生发展研究院科研项目(2017NJMUKD005)。

摘　　要：目的分析MRI在鉴别骨质疏松性椎体骨折及转移性肿瘤所致椎骨骨折中的应用价值。方法收集在本院2017年9月至2019年10月收治的69例椎体骨折者临床资料。骨质疏松性椎体骨折46例,转移性肿瘤所致椎骨骨折23例。对患者所得MRI图像进行分析,研究MRI对两者的鉴别诊断价值。结果(1)骨质疏松性椎体骨折MRI表现:46例患者中共91个椎体出现压缩性变形,可为楔形、双凹形、扁平形。45.05%椎体压迫硬膜囊。病变椎体边缘不规则,T_(1)WI为低信号,T_(2)WI高信号;椎弓根7例存在异常信号,形态无改变;椎体椎间盘在T_(2)WI信号降低,可见有Schmorl结节;周围软组织无异常;增强均匀强化,信号与周围椎体无差异。(2)转移性肿瘤所致椎骨骨折MRI表现:23例患者有57个椎体受累,椎体形态改变,前后径增长,78.94%椎体皮质后部弧形后突压迫硬膜囊;椎体受累以胸腰段常见(78.43%),连续多个椎体受累占76.47%;T_(1)WI为弥漫性低信号,T_(2)WI为高信号,信号不均匀;椎弓根信号异常,明显膨大;椎体临近椎间盘无明显异常信号;77.19%椎体周围异常软组织信号影;56.17%软组织肿块突入椎管且压迫硬膜囊;增强为不均匀强化,周围软组织肿块明显强化。结论骨质疏松性椎体骨折、转移性肿瘤所致椎骨骨折MRI检查图像表现中存在差异性,MRI可为两者鉴别诊断提供重要参考资料,临床使用价值高。Objective To analyze the application value of MRI in differentiating osteoporotic vertebral fractures from vertebral fractures caused by metastatic tumors.Methods The clinical data of 69 patients with vertebral fractures admitted to our hospital from September 2017 to October 2019 were collected.There were 46 cases with osteoporotic vertebral fractures and 23 cases with vertebral fractures caused by metastatic tumors.The MRI images of the patients were analyzed to study their differential diagnosis value.Results(1)MRI manifestations of osteoporotic vertebral fractures:in total,91 vertebrae in 46 patients showed compressive deformation,which could be wedge-shaped,biconcave,and flat.45.05%vertebral body compressed the dural sac.The edge of the diseased vertebral body was irregular,T_(1)WI showed a low signal,and T_(2)WI showed a high signal.In 7 cases,the pedicle of the vertebral arch showed abnormal signals and showed no change in shape.The T_(2)WI signal of the vertebral disc is reduced,and Schmorl nodules can be seen.There was no abnormality in the surrounding soft tissue;the enhancement showed uniform enhancement,and there was no difference in signal with the surrounding vertebra.(2)MRI manifestations of vertebral fractures caused by metastatic tumors:In 23 patients,57 vertebral bodies were involved,the shape of the vertebral body changed,and the anteroposterior diameter increased.The posterior arc of 78.94%vertebral cortex protruded backward and compressed the dural sac.Involvement of the vertebral body was more common in the thoracolumbar region(78.43%).The involvement of multiple consecutive vertebral bodies accounted for 76.47%.T_(1)WI showed diffuse low signal,T_(2)WI showed high signal,and the signal was uneven;the signal of the pedicle of the vertebral arch was abnormal,showing obvious enlargement.There was no obvious abnormal signal in the intervertebral disc adjacent to the vertebral body.77.19%vertebral body showed abnormal soft tissue signal shadows around it.56.17%soft tissue masses protruded into t

关 键 词：MRI 骨质疏松性椎体骨折 转移性肿瘤所致椎骨骨折 应用价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R683[医药卫生—诊断学]