X线、MRI诊断原发性骨质疏松椎体压缩性骨折的价值

The Value of X-ray and MRI in the Diagnosis of Primary Osteoporotic Compression Fracture of Vertebral Body

目的探讨X线、MRI诊断原发性骨质疏松椎体压缩性骨折的临床价值。方法选取2018年4月~2019年4月在我院诊治的96例椎体压缩性骨折患者为研究对象,根据疾病良恶性分为观察组和对照组,观察组为53例原发性骨质疏松症椎体压缩性骨折,对照组为43例转移瘤继发性椎体压缩性骨折,比较两组X线片、MRI影像图像特点。结果观察组X线检出椎体骨折72例,以凹陷形为主(65.27%),椎体骨密度降低占93.05%,椎管变形占11.11%,累及终板占30.55%。对照组X线检出椎体骨折23例,形态以楔形压缩为主(56.52%),椎管狭窄占17.39%,累及终板占26.09%。MRI检查出观察组椎体后缘上角或下角后翘占97.22%,T1WI序列显示局限性低信号占38.89%,T2WI脂肪抑制序列显示高信号占58.33%;对照组圆隆状椎体后缘占96.07%,不规则结节状椎体旁软组织肿块占72.54%,骨折病灶T1WI显示弥漫性低信号占86.27%,T2WI脂肪抑制序列显示高信号占92.15%,增强扫描显示明显强化。结论X线、MRI均可鉴别诊断原发性骨质疏松椎体压缩性骨折和转移瘤继发性椎体压缩性骨折,临床应根据患者具体情况,选择适宜的方案进行检查。

Objective To explore the clinical value of X-ray and MRI in the diagnosis of primary osteoporotic compression fracture of vertebral body.Methods A total of 96 patients with compression fracture of vertebral body diagnosed and treated in our hospital from April 2018 to April 2019 were selected as research subjects.They were divided into observation group and control group according to the benign and malignant disease,and observation group was 53 cases of primary osteoporosis compression fracture of vertebral body in the control group were 43 cases of secondary compression fracture of vertebral body with metastases in the control group.The characteristics of X-ray films and MRI images were compared between the two groups.Results X-ray examination showed that 72 cases of compression fracture of vertebral body in the observation group were mainly depressed(65.27%).The decrease of vertebral bone density accounted for 93.05%,the spinal canal deformation accounted for 11.11%,and the endplate involved 30.55%.In the control group,23 cases of vertebral fractures were detected by X-ray.The shape was mainly wedge-shaped compression(56.52%),spinal canal stenosis accounted for 17.39%,and endplate involvement involved 26.09%.MRI showed that the upper or lower angle of the posterior margin of the vertebral body in the observation group accounted for 97.22%.T1WI sequence showed localized low signal accounted for 38.89%,T2WI fat inhibition sequence showed high signal accounted for 58.33%;control group rounded vertebral posterior margin accounted for 96.07%,irregular nodular paravertebral soft tissue mass accounted for 72.54%,fracture Lesion T1WI showed diffuse low signal accounting for 86.27,T2WI fat suppression sequence showed high signal accounting for 92.15%,and enhanced scan showed significant enhancement.Conclusion X-ray and MRI can differentiate primary osteoporotic compression fracture of vertebral body and metastatic tumor secondary compression fracture of vertebral body.The appropriate scheme should be selected according to the specific situation of the patient.