脊柱良恶性压缩骨折的MR波谱分析

Malignant and benign vertebral compression fractures:MR spectroscopy

目的探讨骨质疏松和恶性肿瘤所致脊柱良恶性压缩骨折的MR氢质子波谱(1HMRS)特征。方法对37例骨质疏松和21例恶性肿瘤所致椎体压缩性骨折病例进行1H MRS采集,同时以30例健康志愿者L2椎体的1H MRS作对照,定量分析感兴趣椎体的脂肪百分含量(FF%)及脂与水的比率(LWR)。结果对照组L2椎体平均脂肪含量为(45.0±20.2)%,平均LWR为0.76;骨质疏松组病变椎体的平均脂肪含量(67.0±14.3)%,平均LWR为1.75;恶性肿瘤组病变椎体平均脂肪含量(1.8±1.2)%;平均LWR为0.1。骨质疏松组FF%和LWR明显高于恶性肿瘤组(t=2.87,P<0.01),亦较高于正常对照组(t=2.06,P<0.05);恶性肿瘤组FF%和LWR明显低于正常对照组(t=2.75,P<0.01)。结论1H MRS能无创性检测脊柱椎体的脂肪含量及LWR,脊柱良恶性压缩椎体的脂肪含量及LWR差异有统计学意义,有助于骨质疏松和恶性肿瘤所致椎体压缩性骨折的鉴别诊断。

Objective To evaluate the characters of proton magnetic resonance spectroscopy （^1H MRS）in the benign and malignant vertebral compression fractures. Methods ^1 H MRS was performed on the vertebral of 30 healthy volunteers, 37 patients with vertebral compression of osteeperosis, and 21 patients with vertebral compression of malignancy. Percent fat fraction（ FF% ）and lipid-to-water ratios （LWR） of ROI were analyzed. Results The mean FF% of normal control subjects was （45.0 ±20. 2）% and the mean LWR was 0. 76 ; The mean FF% of the osteoperosis group was （67. 0 ± 14. 3） % and the mean LWR was 1.75 ; The mean FF% of the malignant group was （ 1.8 ± 1.2） % and the mean LWR was 0. 1 . The FF% and the LWR of osteoperosis group were higher than those of malignant group （ t = 2. 87, P 〈 0. 01 ） and normal control subjects（ t = 2. 06, P 〈 0. 05 ）, the FF% and the LWR of malignant group were lower than that of the normal control subjects （ t = 2. 75, P 〈 0. 01 ）. Conclusion ^1H MRS can noninvasively provide percent fat fraction and lipid-to-water of vertebral. ^1H MRS is helpful in differentiation in between osteeperosis and malignant vertebral compression fractures.