骨质疏松性椎体压缩性骨折急性期MRI信号与经皮椎体后凸成形术疗效的相关性

Relationship between MRI sign and outcome of percutaneous kyphoplasty in acute phase of osteoporotic vertebral compression fracture

目的观察骨质疏松性椎体压缩性骨折（OVCF）急性期MRI影像学特点及其与经皮椎体后凸成形术（PKP）疗效之间的关系。方法纳入行PKP治疗的急性期单节段OVCF患者101例，其中男19例，女82例；年龄61～89岁，平均69．3岁。根据MRI中T2WI信号高低分为低信号组（A组）、中低信号组（B组）、中等信号组（C组）及中高信号组（D组）。采用视觉模拟评分（VAS）评价患者疼痛情况，分析各组患者MRI信号与椎体高度、椎体压缩率、Cobb角变化的相关性。结果所有骨折椎体MRI影像表现为T1WI低信号，FS—T2WI高信号，而T2WI中只有14个椎体呈中高信号，18个椎体呈中等信号，31个椎体呈中低信号，38个椎体呈低信号。四组VAS评分、椎体高度、椎体压缩率、Cobb角术前术后比较差异均有统计学意义（P〈0．05）。结论OVCF急性期MRI中T2WI以低、中等信号为主，与PKP术疗效无明显相关性，但PKP对OVCF的疗效肯定。

Objective To observe the correlation of MRI findings with treatment outcome of percutaneous kyphoplasty （PKP） in the acute phase of osteoporotie vertebral compression fracture （OVCF）. Methods A total of 101 patients with single-segment OVCF undergone PKP in the acute phase were included in the study. There were 19 males and 82 females, at age range of 61 to 89 years （mean, 69.3 years）. According to the T2WI signal intensity, the patients were divided into low signal group （Group A）, low-medium signal group （Group B）, medium signal group （Group C）, and medium- high signal group （ Group D ）. visual analogue scale （ VAS ） was used to evaluating the pain relief. Correlations of MRI signal with vertebral height, vertebral compression ratio, Cobb＇s angle change in each group were determined. Results All MRI images were shown as low signal in T1WI and high signal in FS-T2WI. On the T2WI images, the signal was medium-high in 14 vertebrae, medium in 18 vertebrae, low-medium in 31 vertebrae, and low in 38 vertebrae. Among four groups, the VAS score, vertebral body height, vertebral compression ratio and Cobb＇s angle changes before operation showed no statistical difference compared with those after operation （ P 〈 0.05 ）. Conclusions MRI findings are primarily low or medium signal on T2WI images in the acute phase of OVCF, which shows insignificant correlation with effect of PKP. However, PKP is effective in the treatment of OVCF.