磁共振鉴别脊柱骨质疏松与脊柱转移瘤所致压缩性骨折的临床价值

Clinical value of MRI in differential diagnosis of compression fracture caused by osteoporosis vertebral and spinal metastasis

目的:探讨磁共振在鉴别脊柱骨质疏松与脊柱转移瘤所致压缩性骨折中的临床价值。方法:回顾2018年3月-2020年3月我院确诊的脊柱转移瘤(13例,18个椎体)和脊柱骨质疏松(15例,37个椎体)所致的压缩性骨折患者,分析椎体形态、信号及椎弓根是否有骨质破坏、椎体后缘形态、椎旁软组织有无肿块等MRI影像特征。采用卡方检验比较两组间差异。结果:转移瘤组以倒楔形为主,椎体后缘形态多向后方膨隆,更容易引起椎弓根骨质破坏、椎旁软组织肿块形成;骨质疏松组椎体形态以楔形、凹陷形为主,椎体后缘碎裂突向椎管所占比例较高,椎弓根受累相对少见,差异均有统计学意义。结论:磁共振在鉴别脊柱转移瘤与骨质疏松所致压缩性骨折中有重要价值。

Objective To investigate the clinical value of MRI in the differential diagnosis of compression fracture caused by osteoporosis vertebral and spinal metastasis.Methods The patients with spinal metastases(13 cases,18 vertebral bodies)and spinal osteoporosis(15 cases,37 vertebral bodies)who were diagnosed in our hospital during March 2018 to March 2020 were retrospectively reviewed.The MRI imaging features including vertebral body shape,signal,vertebral pebble bone destruction,vertebral posterior edge shape,and paravertebral soft tissue mass were analyzed.Chi-square test was used to compare the differences between the two groups.Results In the metastatic tumor group,the shape of the posterior edge of the vertebral body was mainly inverted wedge,which was more likely to cause pedicle bone destruction and paravertebral soft tissue mass formation.In the osteoporosis group,the shape of the vertebral body was mainly wedge-shaped and concave,and the proportion of the posterior edge of the vertebral body fragmentation protruding to the spinal canal was higher,and the pedicle involvement was relatively rare,the differences were statistically significant.Conclusion MRI has an important value in the differential diagnosis of spinal metastasis and osteoporotic compression fractures.