MRI-STIR黑色信号线对骨质疏松性椎体压缩骨折患者PVP疗效的预测价值  

Predictive Value of MRI-STIR Black Signal Line for PVP Efficacy in Patients with Osteoporotic Vertebral Compression Fractures

作　　者：吴雨菲 张博[2] 栗先增[2] WU Yufei;ZHANG Bo;LI Xianzeng(Suzhou Medical College,Soochow University,Suzhou 215000,China;Department of Rehabilition,Second Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学苏州医学院,江苏苏州215000 [2]苏州大学附属第二医院康复科,江苏苏州215000

出　　处：《中国伤残医学》2025年第5期40-45,共6页Chinese Journal of Trauma and Disability Medicine

基　　金：2022年江苏省大学生创新创业训练计划项目(202210285181Y);2021苏州市科技计划(社会发展科技创新)项目(SS202146)。

摘　　要：目的:探讨磁共振成像中短波逆转恢复序列(STIR)的黑色信号线对骨质疏松性椎体压缩骨折患者椎体成形术(PVP)疗效的预测价值。方法:本研究开展时间为2022年2月—2023年12月,共纳入在苏州大学附属第二医院接受治疗的123例骨质疏松性椎体压缩骨折患者为研究对象,所有患者均接受MRI-STIR和QCT检查,并在确诊后进行了PVP治疗。根据MRI-STIR中黑色信号线有无将患者分为有信号组(n=50)和无信号组(n=73),并接受6个月随访。结果:两组椎体病灶分布情况、信号变化情况、椎旁肿块信号变化情况、临近椎体信号变化情况比较,差异均有统计学意义(P<0.05)。两组骨水泥注射量比较,差异无统计学意义(P>0.05);有信号组骨密度低于无信号组,骨水泥渗漏发生率、弥散度不佳发生率均高于无信号组,差异均有统计学意义(P<0.05)。术前及术后3个月,两组视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05);术后3、7d,有信号组VAS评分均高于无信号组,差异均有统计学意义(P<0.05)。术后3、7d及术后3个月,有信号组奥斯韦斯特里功能障碍指数评分均高于无信号组,差异均有统计学意义(P<0.05)。术前及术后3、7d、术后3个月,两组伤椎高度比、Cobb角比较,差异均无统计学意义(P>0.05)。术后6个月,有信号组再发骨折率、Cobb角变化及椎体高度丢失发生率均高于无信号组,差异均有统计学意义(P<0.05)。结论:有MRI-STIR黑色信号线的患者骨密度较低,PVP治疗中骨水泥渗漏及弥散度不佳的发生率较高,且术后短期内疼痛和功能障碍评分较高,长期随访中再发骨折及椎体结构变化的风险也较大,因此MRI-STIR的黑色信号线可以作为评估椎体压缩骨折患者疗效和预后风险的重要指标。Objective:To Explore the predictive value of black signal lines of short wave reversal recovery sequence(STIR)in magnetic resonance imaging for the efficacy of vertebral augmentation(PVP)in patients with osteoporotic vertebral compression fractures.Methods:The study was conducted from February 2022 to December 2023,including 123 patients with osteoporotic vertebral compression fractures treated in our hospital,all of whom underwent MRI-STIR and QCT and underwent PVP after diagnosis.Patients were divided into two groups based on the black signal line in MRI-STIR:those with signal(n=50)and no signal(n=73)and followed for 6 months.Results:There was a statistically significant difference in the distribution of vertebral lesions,signal changes,paraspinal mass signal changes,and adjacent vertebral body signal changes between the two groups(P<0.05).There was no statistically significant difference in the injection volume of bone cement between the two groups(P>0.05);the bone density of patients in the signal group was lower than that in the non signal group,and the incidence of bone cement leakage and poor diffusion were higher than that in the non signal group,with statistically significant differences between the groups(P<0.05).Before surgery and 3 months after surgery,there was no statistically significant difference in Visual Analog Scale(VAS)scores between the two groups(P>0.05);on postoperative days 3 and 7,the VAS scores in the signal group were higher than those in the non signal group,and the difference were statistically significant(P<0.05).At 3,7 days,and 3 months after surgery,the Oswestry Disability Index scores of patients in the signal group were higher than those in the non signal group,and the difference were statistically significant(P<0.05).There was no statistically significant difference in the height ratio and Cobb angle of the injured vertebrae between the two groups before Surgery and 7 days,and 3 months after surgery(P>0.05).Six months after surgery,the incidence of recurrent fractures,Cobb angl

关 键 词：磁共振成像中短波逆转恢复序列 骨质疏松性椎体压缩骨折 椎体成形术 骨密度 

分 类 号：R687.3[医药卫生—骨科学]