骨质疏松椎体骨折磁共振STIR信号改变与CT骨折线类型的关系

Relationship between MRI-STIR signal changes and CTfracture line types of osteoporotic vertebral fractures

目的探讨骨质疏松椎体骨折磁共振(MRI)-短反转时间反转恢复序列(STIR)信号改变与电子计算机断层扫描(CT)骨折线类型的关系。方法回顾性分析收治的108例骨质疏松椎体骨折患者临床资料以及MRI、CT影像学征象。比较不同MRI-STIR信号改变患者的CT骨折线类型及CT值。结果经MRI检查,入组患者骨折椎体数共121节,STIR序列呈现黑色线信号45节,无同源高信号36节,同源高信号40节;CT显示,骨折线嵌插型51节,开裂型33节,微骨折型37节。MRI-STIR序列呈现黑色线信号的患者椎体CT骨折线为嵌插型阳性率高于无同源高信号和同源高信号,差异有统计学意义(P<0.05);MRI-STIR序列呈现同源高信号的患者椎体CT骨折线为微骨折型阳性率高于黑色线信号和无同源高信号,差异有统计学意义(P<0.05)。MRI-STIR序列呈现黑色线信号的患者椎体CT值低于无同源高信号和同源高信号,差异有统计学意义(P<0.05)。结论MRI-STIR信号改变与CT骨折线类型存在一定相关性。STIR序列呈现黑色线信号的患者出现椎体嵌插型骨折风险更高,且预后较差。

Objective To explore the relationship between magnetic resonance imaging(MRI)-short time inversion recovery(STIR)signal changes and computerized tomography(CT)fracture line types of osteoporotic vertebral fractures.Methods The clinical data and MRI as well as CT imaging signs of 108 patients with osteoporotic vertebral fractures were retrospectively analyzed.The types of CT fracture lines and CT values of patients changed by different MRI-STIR signals were compared.Results After MRI examination,a total of 121 vertebrae were fractured in the enrolled patients.STIR sequence showed 45 sections of black line signal,36 sections of no homologous high signal and 40 sections of homologous high signal;CT showed that there were 51 cases of fracture line insertion,33 cases of fracture cracking and 37 cases of microfracture.The positive rate of vertebral CT fracture line with intercalation type was significantly higher in patients with no homologous high signal and homologous high signal with MRI-STIR sequence(P<0.05);the positive rate of vertebral CT fracture line with microfracture type in patients with homologous high signal on MRI-STIR sequence was significantly higher than that with black line signal and without homologous high signal(P<0.05);the vertebral CT value of patients with black line signal shown in MRI-STIR sequence was significantly lower than that of patients without homologous high signal and homologous high signal(P<0.05).Conclusion There is a certain correlation between the changes of MRI-STIR signal and the type of CT fracture line.Patients with STIR sequences showing black line signals have a higher risk of vertebral impingement fracture and a poor prognosis.