椎体骨质疏松骨折与转移瘤骨折的MRI形态差异

MRI differential diagnosis for vertebral osteoporotic fracture and vertebral metastatic fracture

目的 探讨椎体骨质疏松性骨折与椎体转移瘤骨折的MRI鉴别要点。 方法 分析31例椎体骨质疏松性骨折和22例椎体转移瘤骨折的MRI影像表现,比较此两类病理性质不同的椎体骨折的MRI形态差异。 结果 椎体骨质疏松性骨折以连续性多椎体骨折多见,椎体骨折以双凹状和楔状变形为主,较少累及附件,较少出现椎旁肿胀,邻近诸椎体通常伴有骨质疏松的信号异常。椎体转移瘤骨折常为单发,病椎可呈多发或跳跃式分布,骨折的椎体以压缩变形多见,常累及椎体的附件,伴有椎旁软组织肿块。两种骨折均较少累及椎间盘,骨折的椎体信号改变均不具有特征性。 结论 依据MRI形态特征可对椎体骨质疏松性骨折与椎体转移瘤骨折作出鉴别诊断。

Objective To evaluate MRI characteristics of vertebral osteoporotic fracture and vertebral metastatic fracture. Methods Manifestations of SE sequence MRI of 31 patients with vertebral osteoporotic fracture and 22 patients with vertebral metastatic fracture were respectively studied. Results Continuous multiple vertebral fracture was common in vertebral osteoporosis, fractural vertebral body often appeared biconcave or wedge deformity. Involvement of vertebral appendix and para-vertebral swelling were uncommon. Abnormal signal intensity of osteoporosis was showed in adjacent vertebral bodies. Single vertebral fracture was common in vertebral metastasis. Metastatic lesions often appeared multiple or skipping distribution in vertebral bodies. Involvement of vertebral appendix and para-vertebral soft tissue mass were often observed in vertebral metastasis. However, characteristic signal abnormality was not found in either vertebral osteoporotic fracture or vertebral metastatic fracture. Involvement of inter-vertebral disc was also rare in both vertebral osteoporotic fracture and vertebral metastatic fracture. Conclusion According to MRI morphologic characteristics, it is possible to differentiate vertebral osteoporotic fracture from vertebral metastatic fracture.