MR T2WI-频率衰减反转恢复序列和扩散张量成像在椎体压缩性骨折恢复过程中的应用价值  

Application value of MR T2WI-spectral attenuated inversion recovery sequence and diffusion tensor imaging in the recovery process of vertebral compression fractures

作　　者：贺顺岭 王存强 原子扬 徐安琪 顾韵泽 HE Shunling;WANG Cunqiang;YUAN Ziyang;XU Anqi;GU Yunze(Department of Magnetic Resonance,Fifth Clinical College,Xinxiang Medical College,Xinxiang First People’s Hospital,Xinxiang,He’nan Province 453000,China)

机构地区：[1]新乡医学院第五临床学院新乡市第一人民医院磁共振科,河南新乡453000

出　　处：《实用放射学杂志》2025年第3期462-466,共5页Journal of Practical Radiology

基　　金：河南省科技攻关基金项目(182102310480)。

摘　　要：目的 探讨 MR T2WI-频率衰减反转恢复(T2WI-SPAIR)序列及扩散张量成像(DTI)在椎体压缩性骨折随时间恢复过程中的价值.方法 选取60~75岁明确受伤时间和方式的3例患者进行8个时间段的 MR常规序列和DTI扫描,动态观察骨折椎体T2WI-SPAIR序列形态及信号的变化,并对骨折椎体与相邻正常椎体的表观扩散系数(ADC)及各向异性分数(FA)进行统计学分析.结果 T2WI-SPAIR序列显示椎体骨折后随时间延长其椎体形态由最初的轻微压缩改变逐渐加重,在>7~9周时椎体上缘局部骨质略塌陷,随后时间趋于稳定;骨折椎体由最初弥漫均匀的高信号逐渐变为混杂信号,在>9~12周时趋于稳定;统计分析结果椎体骨折区在骨折损伤后>1~2周、>3~5周时均与>9~12周时ADC值有明显差异(P<0.05),骨折损伤后≤1周、>1~2周、>3~5周、>12周时均与>9~12周时FA值有明显差异(P<0.05);椎体骨折区与正常区在骨折损伤后的12周之前ADC值及FA值均有明显差异(P<0.05).结论 T2WI-SPAIR序列在显示骨折椎体恢复过程中形态和信号改变以及DTI参数ADC值和FA值在骨折区自身对比和正常区对比中的变化均符合一定的规律,可为临床医师决策治疗方案以及判断椎体损伤时间提供可靠的影像学依据.Objective To explore the value of MR T2WI-spectral attenuated inversion recovery(T2WI-SPAIR)sequence and diffusion tensor imaging(DTI)in the recovery process of vertebral compression fractures over time.Methods Three patients aged 60-75 years with a clear time and mechanism of injury were selected.They underwent conventional MR sequences and DTI scans at eight time points.The morphological and signal changes of the fractured vertebrae on T2WI-SPAIR sequences were dynamically observed.Statistical analysis was performed on the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)of the fractured vertebrae and adjacent normal vertebrae.Results T2WI-SPAIR sequence showed that the vertebral morphology gradually worsened from the initial mild compression changes over time after vertebral fracture.Local bone collapse occurred at the upper edge of the vertebrae at>7-9 weeks,followed by stabilization.The initially diffuse and uniform high signal of the fractured vertebrae gradually changed a mixed signal,stabilizing around>9-12 weeks.Statistical analysis results revealed significant differences in ADC values between>1-2 weeks,>3-5 weeks,and>9-12 weeks post-fracture(P<0.05).Significant differences in FA values were also observed between≤1 week,>1-2 weeks,>3-5 weeks,>12 weeks,and>9-12 weeks post-fracture(P<0.05).Furthermore,ADC and FA values between the fractured and normal vertebrae also showed significant differences within the first 12 weeks postfracture(P<0.05).Conclusion The T2WI-SPAIR sequence demonstrates specific patterns of morphological and signal changes during the recovery process of fractured vertebrae.Changes in DTI parameters,including ADC and FA values,in self-comparison within the fracture zone and comparison with normal regions,follow certain patterns.These findings can provide reliable imaging evidence for clinicians to make treatment decisions and estimate the time of vertebral injury.

关 键 词：椎体压缩性骨折 磁共振成像 频率衰减反转恢复 扩散张量成像 

分 类 号：R683[医药卫生—骨科学] R445.2[医药卫生—外科学]