横行致密带—多层螺旋CT诊断胸腰椎屈曲压缩型骨折的重要征象

Transverse compact zone----a significant appearance in thoracolumbar vertebrae flexion compressibility fracture diagnosed with multislice CT

目的分析多层螺旋CT的MPR重组图像中横行致密带在诊断胸腰椎屈曲压缩型骨折中的应用价值。方法对43例患者胸腰椎的MPR重组图像及21例1-12个月后复查的MPR重组图像的横行致密带进行了回顾性分析。结果其中屈曲压缩型骨折42例共累及60个椎体:横行致密带为唯一征象13个椎体;横行致密带并骨皮质皱折8个椎体;横行致密带、骨皮质皱折并骨折线12个椎体;横行致密带并骨折线25个椎体;无横行致密带的骨折2个椎体。21例34个椎体1-12月后复查见:致密带增厚、致密19个椎体,其中首次漏诊2个;致密带吸收碎裂、骨折线模糊14个椎体;致密带无变化1个椎体。结论横行致密带是多层螺旋CT诊断胸腰椎屈曲压缩型骨折的重要征象之一;在无明确外伤史或轻微屈曲压缩型骨折的早期诊断及鉴别新旧胸腰椎屈曲压缩型骨折中发挥着重要作用,可为医疗纠纷及法医鉴定工作提供重要的影像学依据。

Objective To explore the applied value of transverse compact zone （TCZ） in thoracolumbar vertebrae flexion compressibility fracture（TLVFCF） on multi-plane reconstruction image（MPRI） of multislice computed tomography （MSCT）. Methods TCZ on MPRI in 43 cases and TCZ on reexamination MPRI in 21 cases among 43 cases after 1-12 month were analysed retrospectively . Results There were 60 vertebrae fracture in 42 cases： 13 vertebrae existed TCZ only, 8 vertebrae with TCZ and osseous cortical rugosity, 12 vertebrae with TCZ, osseous cortical rugosity and fracture line, 25 vertebrae with TCZ and fracture line, 2 vertebrae with burst fracture but without TCZ. 34 vertebrae of 21 cases among 43 cases were reexamined after 1-12 month ： TCZ broadened and thickened in 19 vertebrae among them 2 vertebrae were missed diagnosed, TCZ absorbed, ruptured and became dim in 14 vertebrae and no change in 1 vertebrae. Conclusion TCZ is one of the significant appearances diagnosing TLVFCF with MSCT. TCZ play a key sole in early diagnosis among no clear traumatic history case and slight TLVFCF case and in differential diagnosis between new and old TLVFCF, therefor TCZ can provide an important image basis for medical tangle and medicolegal expertise. [