椎体形态改变在影像诊断中的价值分析

Value of vertebral body shape change in image diagnosis

目的探讨不同的椎体形态改变在X光片,CT及MRI影像诊断疾病中的意义及价值。方法选取2018年3月至2020年4月在鹤山市人民医院就诊的301例有椎体形态改变的患者作为研究对象。回顾性分析其临床、影像学、病理资料及复习相关特殊病例的文献资料。结果301例患者中有椎体急性楔形改变(98例压缩性骨折),急性终板弯曲(52例压缩性骨折),慢性终板局部缺损(80例许莫氏结节),13例慢性前缘局部分离(椎缘骨),方形椎、竹节椎(10例强直性脊柱炎),25例椎体双面凹(鱼口椎),5例半椎畸形、蝴蝶椎,2例融合椎,椎体垂直栅栏样改变(10例血管瘤)、3例椎体脂肪瘤,椎体三明治样改变(3例石骨症)。特殊病例文献资料中有扁平椎,椎体前部下行性鸟嘴样变[Hurler综合征(赫勒氏综合征)、粘多糖I型],终板台阶状中心压迹(H形椎)-镰状细胞性贫血,椎体后缘多发扇形改变(神经纤维瘤病),椎体相框征伴粗大骨小梁(Peget病畸形性骨炎),橄榄球衣条纹征(甲状旁腺功能亢进)。结论在影像检查过程中,通过观察椎体形态改变,能够辅助临床判断一些疾病分类,为临床诊断疾病多提供一条路径。

【Objective】To explore the significance and value of different vertebral morphological changes in the diagnosis of diseases by X-ray,CT and MRI.【Methods】From March 2018 to April 2020,301 patients with vertebral body shape changes were selected as the study objects.The clinical characteristics,imaging,pathological data were retrospectively analyzed and relevant special case literature were reviewed.【Results】Among the 301 patients,there were acute cuneiform changes(98 compression fractures),acute endplate bending(52 compression fractures),chronic local defect of endplate(80 Schmorl's nodules),chronic anterior edge local separation(vertebra marginal bone)in 13,square vertebra,bamboo vertebra(10 ankylosing spondylitis),double concave vertebra(fish mouth vertebra)in 25,hemivertebra deformity,butterfly vertebra in 5,fusion vertebra in 2,10 cases of vertebral vertical palisade(hemangioma),3 cases of vertebral lipoma,and 3 cases of vertebral sandwich(osteopetrosis).In the literature of special cases,there were flattened vertebrae,downward bird's beak like change(Hurler's syndrome,mucopolysaccharide type I)in the front of vertebrae,stepped central impression of endplate(H-shaped vertebrae)-sickle cell anemia;multiple fanshaped changes(neurofibromatosis)in the posterior margin of vertebrae,vertebral frame syndrome with coarse bone trabecula(peget's disease),rugby strip syndrome(hyperparathyroidism).【Conclusion】In the process of image examination,by observing the shape change of vertebral body,it can help to judge the classification of some diseases and provide more paths for clinical diagnosis.