中老年胸腰椎压缩性骨折MRI诊断价值

The Diagnostic Value of MRI for Thoracolumbar Compression Fractures of the Middle and Old Age Patients

目的:研究病史明确的中老年胸腰椎压缩性骨折MRI征象,探讨MRI在中老年胸腰椎压缩性骨折中鉴别诊断价值。材料与方法:分析有外伤史及肿瘤病史各22例(共60椎)中老年患者胸腰椎压缩性骨折MRI影像资料,分别对患者病变胸、腰椎的形态及T1WI、T2WI、FS T2WI或STIR、DWI信号进行研究。结果:外伤性胸腰椎压缩性骨折椎体变扁或楔形改变26椎,椎体前后缘上下角突出20椎,21椎椎体内可见部分正常骨髓信号,2椎椎管内及椎旁见血肿形成。26椎椎体内见前后方向走形异常信号带,T1WI低信号带23椎、T2WI表现为高信号或等低信号18椎,T2WI FS或STIR呈明显高信号26椎。椎体前中部前后方向带状或线样水样信号9椎。2个椎体椎弓根见异常信号,但形态未见异常。转移性胸腰椎压缩性骨折椎体上下缘凹陷9椎,楔形变18椎,4椎呈局限性凹陷型,椎体变扁3椎。椎体前后缘膨隆23椎,20椎全椎体信号异常,呈T1WI低信号,T2WI表现为等、稍高、高信号等混杂信号,T2WI FS或STIR呈明显高信号。椎管内或椎旁软组织肿块7椎。椎弓根形态及信号异常11椎。结论:MRI在中老年胸腰椎外伤性压缩骨折与转移性压缩骨折鉴别诊断中具有重要价值。

Purpose： to study the MRI signs of thoracolumbar compression fracture for the middle and old age pa- tients with concrete history, to investigate the differential diagnostic value of MRI for thoracolumbar compression fractures of the middle and old age patients. Materials and Methods： To analysis MRI findings of 44 cases （60 vertebrae） with Injury and tumor history suffered from thoracolumbar compression fracture, to study the forms and signals of the vertebral body with disease on TIWI, T2 WI, FS T2 WI or STIR, DWI. Results： The MRI appearances of thoracolumbar traumatic compression fracture were as follows ： 26 vertebraes presented flat or wedge-shaped, the upper and lower angle of vertebral margin presented prominent 20 vertebrae, the part of normal bone marrow signal was visible 21 vertebrae, 2 vertebraes presented hematomas in intraspinal and paravertebral. The vertebral presented abnormal signal from front to back 26 vertebrae, 23 vertebraes showed hypointense on T1WI, 18 vertebraes showed hyper or iso-or hypo intense on T2WI, abnormally hyperintense on T2WI FS or STIR 26 vertebrae, the front-central vertebral showed banded or threadlike water signal 9 vertebrae. The pedicle showed ab- normal signal 2 vertebrae, but vertebral modality was normal. The MRI appearances of metastatic thoracolumbar vertebral com- pression fractures were as follows： 1 the concave on the upper and lower margin of the vertebral body were 9 vertebrae, wed- ging 18 vertebrae, localized concave 4 vertebrae, vertebral body presented flat 3 vertebrae. The anterior and posterior margin of vertebral was bloated 23 vertebrae, the entire vertebral showed abnormal signal 20 vertebrae, low signal on T1WI, the bone marrow presented mixed intensity onT2 WI, abnormally hyperintense on T2 WI FS or STIR. The soft tissue masses in intraspinal and paravertebral 7 vertebrae, modality and signals of pedicle showed abnormal 11 vertebrae. Conclusion： MRI has important value for the differential diagnosis from thoracolumbar traumatic compression fracture to transferable compression fracture of the middle and old age patients.