骨质疏松性椎体压缩骨折术后磁共振信号变化特征及其临床意义

The characteristics and clinical value of MRI signal changes in osteoporotic vertebral compressive fracture(OVCF)in kyphoplasty

目的探讨骨质疏松性椎体压缩骨折后凸成形术后椎体内磁共振信号改变特征及其临床意义。方法选择17例骨质疏松性椎体压缩骨折椎体行后凸成形术患者,对其术后2w内,2w～3个月,3～6个月,6～12个月等不同时间段骨折椎体内MRI信号变化特征进行比较分析,总结不同时间MRI信号强度变化规律并探讨信号变化所反映的病理生理及临床意义。结果术后2w椎体内MRI信号变化最明显,2w～3个月椎体内高低信号混杂;术后3～6个月临床骨折愈合期后椎体内信号仍多为混杂,但信号强度进一步减低;术后6～12个月椎体内MRI信号恢复正常。结论术后MRI信号从影像学角度反映椎体内病理生理变化,为观察骨质疏松椎体骨折后凸成形术术后临床愈合提供了一种更直观的影像学工具。

Objective To investigate the characteristics and clinical value of MRI signal changes in osteoporotic vertebral compressive fracture（OVCF） in kyphoplasty. Methods Seventeen patients with OVCF were involved. The changes of MRI signals inside the fractured intervertebral body were recorded and compared at different time postoperatively, which were 2 weeks, 2 weeks to 3 months, 3 to 6 months, and 6 to 12 months. The changing pattern of the signal was summarized, and the pathological, physiological and clinical significance were analyzed. Results MRI signal changed the most 2 weeks after surgery. 2 weeks to 3 months post-operatively, the high and low signals were mixed. 3 to 6 months post-operatively, the signals were still mixed after the healing phase of the fracture, but the intensity weakened. 6 to 12 months post-operatively, the MRI signals were normal. Conclusions Post-operative MRI signals reflect the pathological and physiological changes. It is a direct-viewing image tool to observe the healing after OVCF.