骨质疏松或骨转移瘤致椎体压缩性骨折的MRI鉴别

Differential Diagnosis of Vertebral Compression Fractures Caused by Osteoporosis and Bone Metastases on MRI

目的比较骨质疏松和骨转移瘤引起椎体压缩性骨折的MRI特点,为临床鉴别诊断提供参考。方法选取脊椎压缩性骨折患者为研究对象,共纳入70例99节椎体,其中31例患者共52节椎体是由骨质疏松引起的,39例患者共47节椎体是由肿瘤转移引起的,比较两者MRI检查中椎体形态,椎体信号,椎体后缘,椎弓根,MRI增强后表现的差异,分析2种椎体病变的特征性表现。结果骨质疏松患者MRI下椎体形态多为楔形、凹陷形,骨转移瘤患者多为倒楔形,其次为扁平形;2组患者MRI下椎体形态及信号具有显著差异(P<0.01)。2组患者椎体后缘形态,椎弓根破坏,椎管内软组织影以及MRI增强后强化具有显著差异(P<0.01)。结论骨质疏松和骨转移瘤所致椎体压缩性骨折的MRI检查具有相应的特征性改变,有助于诊断及临床鉴别。

Objective To compare the characteristics of vertebral compression fractures caused by osteoporosis and bone metastases on MRI ,and provide a reference for clinical differential diagnosis .Methods 70 case of vertebral compression frac-tures(99 vertebrae)were selected.31 cases(52 vertebrae)were caused by osteoporosis,and 39 cases(47 vertebrae) were caused by bone metastases.Changes of vertebral shape and signal ,vertebral posterior edge,pedicle,and performance difference after en-hanced MRI of the 2 groups were observed ,and the characteristics of the 2 groups were analyzed .Results The osteoporotic com-pression fractures were maily wedge-shaped and SAG-shaped, and the metastatic compression fractures were mainly inverted wedge-shaped and flattened .There had obvious differences in the vertebral morphology and signal under MRI between the 2 groups.There had obvious differences in vertebral posterior form ,pedicle damage,spinal soft tissue shadow and the MRI enhance-ment between the 2 groups.Conclusion Vertebral compression fractures caused by osteoporosis and bone metastases on MRI has different characteristics ,and it is beneficial to clinical differential diagnosis .