MRI影像学参数变化与脊柱骨折患者术后功能恢复的相关性  

Correlation between changes of MRI imaging parameters and postoperative functional recovery in patients with spinal fractures

作　　者：刘霞 车艳杰 LIU Xia;CHE Yan-jie(Department of Imaging,The No.4 People’s Hospital of Hengshui,Hengshui053000,Hebei,China)

机构地区：[1]衡水市第四人民医院影像科,河北衡水053000

出　　处：《生物医学工程与临床》2024年第5期668-672,共5页Biomedical Engineering and Clinical Medicine

基　　金：衡水市科技计划项目(2022014018Z)。

摘　　要：目的研究MRI影像学参数变化与脊柱骨折患者术后功能恢复的相关性。方法选择衡水市第四人民医院于2020年1月至2023年1月收治的200例脊柱骨折患者,其中男性117例,女性83例;年龄43~68岁,平均年龄48.62岁;脊髓损伤节段胸椎78例,腰椎122例;高处坠落93例,重物压伤61例,交通事故46例。均接受常规经皮椎体成形术治疗,在术前和术后3个月接受MRI检查,根据术后3个月T_(2)加权成像(T_(2)WI)信号变化情况分为信号强度减少组、信号强度不变组和信号强度增加组。评估日本矫形外科协会(JOA)评分,比较3组患者治疗效果,以及治疗前后JOA评分、X射线指标变化情况。结果术后3个月,T_(2)WI信号强度减少者128例,信号强度不变者24例,信号强度增加者48例。治疗后JOA评分均明显增加,其中信号强度减少患者的变化值明显高于信号强度不变、信号强度增加患者[(25.27±1.12)分vs(24.34±1.17)分、(25.27±1.12)分vs(23.38±1.23)分。P<0.05]。治疗后Cobb's角、椎体前缘高度、椎体后缘高度均明显增加,其中信号强度减少患者X射线指标均高于信号强度不变、信号强度增加患者[(4.27±1.12)°vs(6.88±1.28)°、(4.27±1.12)°vs(7.16±1.52)°,(91.78±7.46)mm vs(85.73±8.44)mm、(91.78±7.46)mm vs(84.67±8.14)mm,(95.53±6.68)mm vs(90.69±6.36)mm、(95.53±6.68)mm vs(88.74±7.23)mm。P<0.05]。经治疗后,信号强度减少患者优良率明显高于信号强度不变、信号强度增加患者[87.50%(112/128)vs 70.83%(17/24)vs 66.67%(32/48)]。结论脊柱骨折功能恢复效果与MRI脊柱骨折处信号强度变化之间关联密切,其中T_(2)WI信号强度降低患者的脊柱骨折功能恢复效果较佳。Objective To study the correlation between changes of MRI imaging parameters and postoperative functional recovery in patients with spinal fracture.Methods From January 2020 to January 2023,a total of 200 patients with spinal fractures were enrolled,which included 117 males and 83 females,aged 43-68 years old with mean age of 48.62 years old.There were 78 cases of thoracic spinal cord injury and 122 of lumbar spinal cord injury;93 cases of falling,61 of crush injury and 46 of traffic accident.All of them performed conventional percutaneous vertebroplasty,and MRI examination was performed before and 3-month post operation.According to changes of T_(2)-weighted imaging(T_(2)WI)signal 3-month post operation,all of them were divided into signal intensity reduction group,signal intensity invariant group and signal intensity increment group.The Japanese Orthopaedic Association(JOA)score was evaluated,the treatment effect,changes in JOA score and X-ray indicators before and after treatment in 3 groups were compared.Results The T_(2)WI signal intensity was reduced in 128 cases,unchanged in 24 cases and increased in 48 cases 3-month post operation.The JOA scores were significantly increased after treatment,and the scores of signal intensity reduction group was significantly higher than that of signal intensity invariant group and signal intensity increment group[(25.27±1.12)scores vs(24.34±1.17)scores,(25.27±1.12)scores vs(23.38±1.23)scores.P<0.05].After treatment,the Cobb’s angle,anterior vertebral height and posterior vertebral height were significantly increased,and the X-ray indexes of signal intensity reduction group were significantly higher than that of signal intensity invariant group and signal intensity increment group[(4.27±1.12)°vs(6.88±1.28)°,(4.27±1.12)°vs(7.16±1.52)°,(91.78±7.46)mm vs(85.73±8.44)mm,(91.78±7.46)mm vs(84.67±8.14)mm,(95.53±6.68)mm vs(90.69±6.36)mm,(95.53±6.68)mm vs(88.74±7.23)mm.P<0.05].After treatment,the superior rate was significantly higher in signal intensity reducti

关 键 词：椎体后凸成形术 脊柱骨折 MRI 功能恢复 相关性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学]