骨质疏松与恶性骨质破坏致椎体压缩性骨折的CT磁共振成像影像特点及鉴别诊断  

CT and MRI features and differential diagnosis of vertebral compression fractures caused by osteoporosis and malignant bone destruction

作　　者：方培[1] Fang Pei(Department of Medical Imaging,Guigang Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine,Guangxi 537100,China)

机构地区：[1]广西壮族自治区贵港市中西医结合骨科医院医学影像科,537100

出　　处：《实用医学影像杂志》2022年第1期18-20,共3页Journal of Practical Medical Imaging

摘　　要：目的探究采用CT、磁共振成像(MRI)鉴别诊断骨质疏松与恶性骨破坏导致的椎体压缩性骨折的临床疗效。方法选择2019年12月至2020年12月经临床诊疗证实为骨质疏松及恶性骨质破坏致脊椎骨折的患者76例,分为2组:A组(骨质疏松改变并伴有压缩性骨折,36例),B组(恶性骨破坏致压缩性骨折,40例)。对比2组患者椎体、椎间盘、附件、软组织肿块并进行统计学比较。结果B组骨折以跳跃性椎体受累为主,A组骨折以连续性椎体受累为主,A组椎间盘压缩、增宽均高于B组(P<0.05),B组椎旁附件受累数目、软组织肿块数目均高于A组(P<0.05)。A组CT结果显示其密度下降明显,无明确骨折线,楔形变椎体后角无异常改变,。MRI结果显示其呈椎体终板下或椎体中央带T_(1)WI稍低T_(2)WI稍高信号。B组CT可见明确骨质破坏,骨折线偶可见。MRI结果显示椎体中央带或附件区T_(1)WI、T_(2)WI混杂信号骨质破坏、抑脂呈中等信号改变,T_(1)WI低信号,T_(2)WI低信号。结论CT联合MRI检查可有效鉴别骨质疏松或恶性骨质破坏导致的椎体压缩性骨折。Objective To explore the clinical effect of CT and MRI in the differential diagnosis of osteoporosis and vertebral compression fractures caused by malignant bone destruction.Methods From December 2019 to December 2020,76 patients with vertebral fractures caused by osteoporosis and malignant bone destruction were divided into two groups:group A(osteoporosis with compression fractures,n=36)and group B(compression fractures caused by malignant bone destruction,n=40).The vertebral body,intervertebral disc,appendage and soft tissue mass were compared between the two groups.Results Skipping vertebral body involvement was the main fracture in group B,and continuous vertebral body involvement was the main fracture in group A.The intervertebral disc compression and widening in group A were higher than those in group B(P<0.05).The number of paravertebral appendages and soft tissue masses in group B were higher than those in group A(P<0.05).The CT results of group A showed that the density decreased significantly,no clear fracture line,wedge-shaped change,no abnormal change of posterior angle of vertebral body.MRI showed that it was slightly low on T_(1)WI and slightly high on T_(2)WI in the vertebral endplate or central zone.In group B,bone destruction and fracture line could be seen on CT.MRI showed mixed signal on T_(1)WI and T_(2)WI,moderate signal on T_(1)WI and T_(2)WI,low signal on T_(1)WI and low signal on T_(2)WI.Conclusion CT combined with MRI can effectively identify vertebral compression fractures caused by osteoporosis or malignant bone destruction.

关 键 词：骨质疏松 恶性骨破坏 椎体压缩性骨折 CT MRI 影像特点 鉴别诊断 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]