MR多种成像技术在原发性骨质疏松椎体骨折鉴别诊断中的应用

Multiple MRI techniques in the diagnosis and differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture

目的 :探讨MR多种成像技术对鉴别原发性骨质疏松椎体骨折与其它原因所致病理性骨折的价值。方法 :对14例原发性骨质疏松椎体压缩骨折和 2 0例转移瘤所致骨折患者行MRI检查 ,成像序列均包括SET1 WI、FSET2 WI、STIR、DWI和增强SET1 WI抑脂序列 ,分析病变椎体在不同MR成像序列上的信号表现 ,计算病变区的强化比率、ADC值和骨髓对比率 ,进行统计学分析。结果 :SET1 WI、FSET2 WI、STIR和增强扫描上病变椎体横形分层样信号、椎体后上角后突及前后径增加、附件信号异常、邻近椎间盘信号增高、局部软组织肿块及椎管内结构受累在两组间发生率差异明显 ,骨质疏松骨折与转移瘤所致骨折的ADC值无显著性差异 (P >0 .0 5 ) ,两者强化比率和骨髓对比率有显著性差异 (P <0 .0 1)。结论

Objective:To study multiple MRI techniques in differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture.Methods:MRI was performed in 14 cases with primary osteoporotic vertebral compression fracture and 20 cases metastatic vertebral compression fracture.The following sequences were used:SE T 1WI,FSE T 2WI,STIR,DWI and enhanced SE T 1WI with fat suppression.The abnormal signal of vertebrae on different MRI sequences was analyzed, enhancement ratios,ADC values and bone marrow contrast ratios of lesions were calculated and statistic analysis was done.Results:The incidence rate of transverse laminar signal,retropulsion of postero superior corner of the vertebral and increased sagittal diameter of vertebrae,the abnormal signal in vertebral appendages,high signal in intervertebral disc,the invasion of soft tissue and vertebral canal demonstrated great difference between two groups.There was no difference of ADC values in two groups ( P >0.05),but the difference in enhancement ratio and bone marrow contrast ratio at DWI was significant ( P <0.01).Conclusion:The combined use of the multiple MRI sequences is very helpful in differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture.