脊椎病变骨髓MRI信号分型初探(附150例报告)

Preliminary Study on Magnetic Resonance Imaging Signal Classification in Bone Marrow of Spinal Disorders(Appendix 150 Cases Report)

目的 探讨脊椎病变骨髓ＭＲＩ信号特点、分型与病理基础。材料和方法 分析１５０例脊椎椎体病变骨髓的ＭＲＩ信号特点，其中骨质疏松压缩性骨折４４例，外伤性骨折５２例，脊椎感染性病变１２例，转移瘤３２例，多发性骨髓瘤４例，慢性粒细胞性白血病１例，神经纤维瘤病２例，嗜酸性肉芽肿１例，总结ＳＥ序列Ｔ１ＷＩ椎体内黄骨髓信号的分布与形态特点并分型。结果 椎体病变骨髓ＭＲＩ信号分６型：Ｏ型，正常骨髓信号，２１例；Ⅰ型，红骨髓缺失型，４例；Ⅱ型，部分骨髓信号保留型，５６例；Ⅲ型，骨髓信号局灶替代型，１６例Ⅳ型，骨髓信号斑片替代型，３例；Ⅴ型，弥漫骨髓低信号型，５６例。结论 脊椎病变保留的黄骨髓信号，其分布与形态具有一定的规律，反映了相应的病理生理基础。将其总结分型，便于正确认识脊椎病变的骨髓ＭＲＩ信号变化，提高脊椎病变的诊断水平。

Purpose To research characters of magnetic resonance imaging(MRI), lesion pattern, pathological base of bone marrow of spinal disorder (SD). Materials and methods Characters of MRI sign in 150 cases with SD including 44 cases of compressed fracture, 52 cases of traumatic fracture, 12 cases of spinal infective diseases, 32 cases of spinal metastasis, 4 cases of multiple myeloma, 1 case of chronic granulocytic leukemia, 2 cases of neurofibromatosis, and 1 case of eosinophile granuloma were analyzed. The Signal classification were made according to characters of distribution of signs and morphological character of T1 - weighted imaging of MRI spin - echo sequence in yellow bone marrow of vertebra Results. The bone marrow MRI signs of SD would be divided into six patterns, that were 0 pattern (MRI sign of normal bone marrow, 21 cases), Ⅰ pattern (red marrow depletion, 4 cases), Ⅱ pattern (partly conservation of bone marrow sign, 56 cases), Ⅲ pattern (focally replacement of bone marrow sign, 16 cases), Ⅳ pattern (spotty replacement of bone marrow sign, 3 cases), Ⅴ pattern (diffuse low sign of bone marrow, 56 cases). Conclusions Distribution and appearance of conservative yellow bone marrow of SD had some regularities, which represent their correspondent pathological bases. Summary and pattern of SD were helpful to correctly recognizing MRI sign changes of bone marrow of SD and increasing diagnostic level of SD.