脊柱转移瘤与压缩骨折的MRI诊断

Magnetic resonance imaging of vertebral metastasis and compression fracture

目的探讨椎体转移瘤与压缩骨折的MRI特征及其对诊断与鉴别诊断的价值。方法25例病理证实的椎体转移瘤及15例临床随访证实的单纯压缩骨折患者,全部行MR平扫及增强扫描。结果压缩椎体的信号对转移瘤与单纯压缩的鉴别无特异性,但椎体内残留有正常骨髓信号者多见于单纯压缩骨折,压缩椎体后缘膨出、椎管狭窄、椎弓受累、椎旁软组织肿块及增强后压缩椎体不均匀性强化多见于转移瘤。结论MRI的特征性改变有助于两者的鉴别诊断。

Objective To investigate the capabilities of MRI features of vertebral metastasis and compression fracture in the diagnosis and differention of the both diseases.Methods Twenty-five patients with pathologically proved vertebral metastases and fifteen patients with clinically proved compression fracture underwent MR imaging without and with contrast enhancement before the operation.All MR imaging was performed with T1 and T2 weitghted sequences.Results Normal marrow preservation of the compressed vertebral body in osteoporotic fractures was similar to that in malignant fractures.Normal marrow signals which remained in vertebral body were mostly found in single compression fracture,while the expansive posterior border of compressed vertebral body,vertebral tube stenosis,vertebral arch involvement,paraverebral soft tissue mass,and heterogenous enhancement of compressed vertebral body after contrast agent administration were mostly found in metastatic tumors.Conclusion Characteristic MR findings of vertebral metastasis are helpful to differentiate this disease from single compression fracture.