磁共振成像与核素骨显像对骨质疏松性椎体骨折诊断的比较

Comparison between MRI and radionuclide bone imaging in the diagnosis of osteoporotic vertebral compressive fracture

目的:比较分析磁共振成像(MRI)与核素骨显像对胸腰椎椎体骨质疏松性骨折诊断的敏感性及特异性。方法:24例(66个节段)胸腰椎骨质疏松性椎体骨折患者,分别行全身核素骨显像和脊柱MRI检查,比较两种方法对椎体发生骨折的显示情况。结果:以受累椎体个数为统计单位,在胸腰椎范围内,共66个椎体确定为责任节段,行椎体后凸成形术;MRI诊断60个节段,核素骨显像诊断58个节段,将两者的诊断个数进行Kappa检验,两者一致性较高,有统计学意义(Kappa=0.72,P=0.000)。结论:在显示骨质疏松性椎体压缩骨折方面,核素骨显像与MRI具有较高的一致性,可作为诊断骨质疏松性椎体骨折责任节段的有效辅助检查方式。

Objective：To compare the value of radionuclide bone imaging and MRI in the diagnosis of osteoporotic vertebral compressive fracture.Method：Between February 2010 and December 2010,a total of 66 vertebrae from 24 cases（4 males and 20 females） with the mean age of 71.5 years old（range,60 to 82 years old） suffering osteoporotic thoraeolumbar vertebral compressive fractures received X Ray,MRI and radionuclide bone imaging in the whole body with 99mTc-MDP,before experienced pereutaneous kyphoplasty,in our hospital.Result： Of the compression vertebrae compared, 60 vertebrae were positive for fracture on MRI and 58 vertebrae by bone scans.Four patients with entirely positive bone scans were negative by MRI,and two patients were entirely positive by MRI but negative by bone scan.The same vertebrae were 56,with a Kappa statistic of 0.72 （P=0.000）,indicating essentially excellent agreement.Conclusion：Radionuclide bone imaging was another good choice for the diagnosis of osteoporotic vertebral compressive fracture.Espoeially for cases exist contraindication of MRI,it could offer a reliable proof to decision-maker.