骨质疏松相关性椎体骨折的MRI诊断与分类

Diagnosis and Classification of MRI to Vertebral Fractures in Patients with Osteoporosis

目的:通过比较MRI与X平片对骨质疏松相关性椎体骨折的诊断成功率,探讨MRI在此类骨折的诊断及决定治疗方案中的作用。方法:选择我院近2年来34例患者共316处骨质疏松相关性椎体骨折,男30例,女4例,年龄61到95岁,平均82岁。比较MRI与X平片对此类骨折的诊断率,观察此类骨折在MRI上信号强度的改变。依据T1相矢状面上信号强度的改变将骨折分为6种类型:全椎体骨折、椎体前部骨折、椎体后部骨折、椎体上部骨折、椎体下部骨折和椎体中心骨折。结果:MRI对骨质疏松相关性椎体骨折的诊断率为98%,而X片为83%,前者明显优于后者。结论:椎体上部骨折和椎体下部骨折两种类型均未发现有椎管内突出受压,而全椎体骨折和椎体后部骨折两种类型的椎管内突出受压的发生率较高。

Objective：The purpose of this study was to investigate the usefulness resonance imaging （MRI） in the diagnosis of,when deciding on treatment policies for,vertebral fractures in patients with osteoporosis by comparing the diagnostic success rates for such fractures using MRI and plain radiographs. Methods：We also devised a new classification of vertebral fractures in osteoporotic patients based on MRI findings. The subjects were 34 patients with a total of 316 osteoporosis related vertebral fractures in our department during the past 2 years. They consisted of 30 women and 4 men with an average age of 82 years （range 61-95 years）.The site diagnostic rates of plain radiographs and MRI for the vertebral fractures were compared,and changes in signal intensity of the fractured vertebrae in MRI were examined. The areas of change in signal intensity in T1-weighted sagittal images were classified into six type：total,anterior,posterior,superior,inferior,central. Results：The site diagnostic rate for vertebral fractures was 98% for MRI,which was better than the 87% obtained with plain radiographs. Conclusion：Changes in signal intensity in the vertebrae showed no intraspinal protrusion in the inferior and superior types,and neurological stability was achieved,but there was a high frequency of intraspinal protrusion in the total and posterior types.