横行致密带征象在MSCT诊断胸腰椎隐匿性骨折中的应用价值

Applied Value of Transverse Compact Zone in MSCT Diagnosis of Thoracolumbar Latent Fracture

目的探讨横行致密带征象在MSCT诊断胸腰椎隐匿性骨折中的诊断价值。资料与方法对胸腰椎MSCT检查证实的隐匿性骨折22例患者26个椎体的影像资料回顾性分析,分成对照组及实验组,对照组:仅观察常规横轴位软组织窗/骨窗图像。实验组:仅观察MPR重组软组织窗/骨窗图像,双盲法分别认证统计各骨折征象(骨折线、骨小梁中断、骨皮质中断、骨小梁集聚、骨皮质皱褶、横行致密带、软组织肿胀)。结果首诊MSCT检查,对照组10个(38%)椎体骨折,4个(15%)椎体见骨折线,3个(11%)椎体见骨皮质中断,8个(31%)椎体见骨小梁聚集。实验组26个(100%)椎体骨折,4个(15%)椎体见骨折线,1个(4%)椎体见骨小梁中断,4个(15%)椎体见骨皮质中断,2个(7%)椎体见骨皮质皱褶,26个(100%)椎体见横行致密带,其中15个(58%)椎体见唯一的横行致密带征象。首诊实验组隐匿性骨折诊断正确率为100%,对照组隐匿性骨折正确率为38%。结论横行致密带征象是MSCT诊断胸腰椎隐匿性骨折的重要征象之一,可以是单纯性骨小梁微骨折的唯一征象。

To evaluate the MSCT diagnosis value of transverse compact zone （CTZ） in thoracolumbar latent fracture Materials and Methods The image data of 22 cases with 26 thoracolumbar latent fracture confirmed by multi-slice spiral CT were divided into control group, which were only observed the conventional horizontal axial soft tissue or bone window images, and experimental group, observed multiple planar reconstruction（MPR） soft tissue or lone window images respectively, and then all fracture sings such as fracture line, bone trabecular interruption, bone cortex interruption, bone trabecular cluster, bone cortical fold, transverse compact zone and soft tissue swelling were retrospectively analyzed. Results 10 cases of vertebral fractures, correctly in 38% in the first examination, including 4 eases of fracture line （in 15%）, 3 cases of bone cortex interruption（in 11%） and 8 cases of bone trabecular cluster （in 31%） were found in control group. 26 vertebral fractures in 22 cases, correctly in 100% in the first examination, including 4 cases of fracture line（in 15%）, 1 cases of bone trabecular interruption （in 4%）, 4 cases of bone cortex interruption （in 15%）, 2 cases of bone cortical hold （in 7%） and 26 transverse compact zone （in 100%） were found. Conclusion CTZ is one of the important signs for MSCT to diagnose thoracolumbar vertebra latent fracture and may be a sole sign in simple bone trabecular micro fracture.