MRI与CT在老年胸腰椎压缩性骨折诊断中的价值比较

Comparison of the value of MRI and CT in the diagnosis of thoracolumbar vertebral compression fractures in the elderly

目的:探讨磁共振(magnetic resonance imaging,MRI)与计算机体层摄影(computerized tomography,CT)在老年胸腰椎压缩性骨折(vertebral compression fractures,VCF)诊断中的价值。方法:选取2020年1月-2022年1月在菏泽市第六人民医院治疗的80例VCF患者,均经手术病理证实。所有患者术前均接受MRI检查与CT检查,对不同检查方法的诊断符合率、影像学结果进行分析。结果:MRI检查、CT检查诊断VCF的符合率分别为95.0%、85.0%,二者差异有统计学意义(P<0.05)。MRI检查共发现93个骨折椎体,其中37个陈旧性VCF中T_(1)、T_(2)加权图像均以等信号及部分低信号进行呈现,且边界硬化,压脂T_(2)加权图像以等信号进行呈现,周围软组织信号正常;而56个新鲜VCF的表现为T_(1)加权图像以低信号呈现,T_(2)加权图像及压脂加权图像以高信号呈现,椎体骨髓发生水肿。结论:MRI检查对老年VCF患者的诊断准确率高于CT检查,同时能够有效显示椎体形态,判断骨折新旧程度。

Objective To explore magnetic resonance imaging(MRI)and computerized tomography(CT)in the diagnosis of vertebral compression fractures(VCF)in elderly patients.Methods A total of 80 patients with VCF who were treated in Heze Sixth People’s Hospital from January 2020 to January 2022 were selected and confirmed by surgery and pathology,all patients underwent MRI and CT examination before operation.The diagnostic coincidence rate and imaging results of different examination methods were analyzed.Results The coincidence rate of MRI and CT in the diagnosis of VCF was 95.0%and 85.0%,respectively,and the difference was statistically significant(P<0.05).A total of 93 fractured vertebrae were found by MRI,among which 37 cases of old VCF were presented with isointensity and partial hypointensity on T_(1) and T_(2) weighted images,and the boundary was hardened.The T_(2)-weighted images of fat compression were presented with isointensity and the surrounding soft tissue signal was normal.The 56 cases of fresh VCF showed hypointensity on T_(1)-weighted images,hyperintensity on T_(2)-weighted images and fat-weighted images,and vertebral bone marrow edema.Conclusion MRI has a higher diagnostic accuracy than CT in elderly patients with VCF,and can effectively display the vertebral shape and judge the degree of fracture.