骨质疏松和转移瘤致椎体压缩骨折的MRI早期鉴别诊断

MRI differential diagnosis of vertebral compression fractures caused by osteoporosis and metastatic at the early stage

目的评价核磁共振成像(MRI)在早期鉴别骨质疏松性椎体骨折(OVCF)与转移瘤性椎体骨折(MVCF)方面的价值。方法回顾性分析32例OVCF和22例MVCF患者骨折早期(≤2月)的MRI资料,观察记录MRI资料中出现椎旁软组织肿块、出现其他椎体转移灶、椎体后缘皮质后凸、椎弓根累及、出现硬膜外肿块、骨折椎体存留正常骨髓信号、椎体后部骨碎块后移、伴随多处椎体骨折这8种征象,所得结果采用SPSS 17.0统计软件进行χ2检验,以P<0.05为差异有统计学意义。结果 MVCF的MRI征象多骨折椎体后缘皮质后凸、椎弓根受累及、出现硬膜外肿块、出现椎旁软组织肿块及出现其他椎体转移灶;OVCF的MRI征象中多有骨折椎体存留正常骨髓信号;差异具有统计学意义(P<0.001)。而椎体后部骨碎块的后移及伴随多处椎体骨折两种征象差异无统计学意义(P>0.05)。结论常规MRI影像技术有助于早期鉴别OVCF与MVCF,具有重要的临床意义。

Objective To evaluate the value of MRI on early identification of osteoporotic vertebral fracture(OCVF) and metastatic vertebral compression fracture(MCVF). Methods Retrospectively reviewed the MRI spine of 32 patients with OVCF and 22 patients with MCVF, observed and record the paraspinal mass of all MRI data, other spinal metastasis, convex posterior border of the vertebral body, pedicle involvement, epidural mass, spared normal bone marrow signal intensity, retropulsion of a posterior bone fragment and multiple compression fracture. The results obtained using the statistical software SPSS 17.0 to analyze, the difference was statistically significant if P<0.05. Results MRI features suggestive of MVCF were convex posterior border of the vertebral body, involvement of the pedicle, epidural mass, paraspinal mass and other spinal metastasis. MR imaging features suggestive of OVCF was spared normal bone marrow signal intensity(P<0.001). Retropulsion of a posterior bone fragment and multiple compression fracture were invaluable in differential diagnosis for OVCF and MCVF(P>0.05). Conclusion The routine MRI symptom contribute to differentiate vertebral osteoporotic fracture from vertebral metastases fracture, and it has important clinical significance.