正反化学位移成像在椎体压缩骨折病因分析中的应用价值

Application of Chemical Shift in Phase and out of Phase for the Differential Diagnosis of Benign and Malignant Vertebral Compression Fractures

目的探讨正反化学位移成像(chemical shift imaging,CSI)在椎体压缩骨折病因分析中的应用价值。方法利用超导核磁共振扫描仪(GE HDX 1.5T)对169例267个椎体进行常规扫描和CSI扫描,测量并计算相对信号强度(反相位信号强度/正相位信号强化,SIR)。根据临床表现、年龄、病理结果和影像学资料将267个椎体分为正常组33例33个椎体,良性压缩骨折组77例103个椎体(40个胸椎、63个腰椎),恶性压缩骨折组59例131个椎体(6个颈椎,50个胸椎,67个腰椎,8个骶椎)。对各组SIR值进行F检验统计学处理。结果 1.正常组相对强度平均值为(0.5117±0.1468)。良性压缩骨折组相对强度平均值为(0.7195±0.1475)。恶性压缩骨折组平均信号强度(0.8458±0.1231)。2.各组间进行独立样本F检验,三组两两比较均有统计学意义(t>1,P<0.05)。结论正常椎体组SIR最小,良性压缩骨折组SIR次之,恶性压缩骨折组SIR最大。正常组与良性组,良性组与恶性组相对信号强度有重叠。CSI成像对椎体压缩骨折的良恶性压缩骨折有鉴别意义。

Objective To evaluate the application value of positive and negative chemical shift imaging （CSI） in tile diagnosis and differential diagnosis of benign and malignant vertebral compression fracture. Methods GE 1.5 T HDX superconducting MRI scanner was adopted on 169 cases （267 vertebral bodies） for positive and negative CSI and conventional scanning, and the relative signal intensities （negative-phase signal strength/ positive-phase signal enhancement, SIR）were measured and calculated. 267 vertebral observation objects were divided into 3 groups according to the clinical manifestations, imaging data, age and pathological results.In normal group, there were 33 cases with 33 vertebral bodies;in benign fracture group, there were 77 cases with 103 vertebral bodies： 40 thoracic vertebra and63 lumbar vertebra;in malignant fracture group,there were 59 cases with 131 vertebral bodies, where 6 were cervical vertebra, 50 were thoracic vertebra, 67 were lumbar vertebra and 8 were sacral vertebra. F test was used for statistics processing of parameters （measurement data） in each group. Results 1.The average relative strengths were （0.5117 ± 0.1468）, （0.7195 ± 0.1475） and （0.8458± 0.1231） in normal group, benign fracture group and malignant fracture group, respectively. 2 Independent sample F test was conducted among the groups. Pairwise comparisons between the three groups were statistically significant （t〉1, P〈0.05）. Conclusion The relative signal strength in normal group is theweakest, which is medium in the benign fracture group and the strongest in the naalignant fracture group. Relative signal strengths have been crossed between the normal group and benign group, as well as between the benign and malignant groups. Positive and negative chemical shift imaging is helpfnl in differentiating benign and malignant compression fracture of vertebral bodies.