摘要
目的 对良、恶性椎体压缩性骨折的MR特征性改变进行分析。方法 回顾性分析经临床和MR确诊的椎体压缩性骨折 16 7例共 2 15个椎体 ,外伤性 98个椎体 ,非外伤性 34个椎体 ,恶性骨折 78个椎体。分别观察压缩椎体的外形、被替代的骨髓信号和类型、骨碎片、椎弓受累、椎旁软组织影和其他椎体改变。结果 恶性骨折的骨髓被完全替代 (I型 ) ,而良性骨折的骨髓以部分替代或完全保留为主 (II型 ,III型 ,P <0 .0 0 1) ;恶性的骨髓病变的边界不规则 ,而外伤和非外伤性的边界规则 (P <0 .0 0 1) ;椎体楔形压缩仅见于外伤和恶性骨折 ,倒楔形压缩仅见于恶性 ,而凹陷形多见于非外伤 (P <0 .0 0 1)。椎间盘撕裂、椎体碎片和椎间隙狭窄或增宽见于良性骨折。椎弓根受累 ,椎旁软组织影和其他椎体转移见于恶性压缩骨折。结论 MR上特征性改变能准确地鉴别良。
Purpose To evaluate the MR imaging characteristics that will supply a MR criteria in diagnosis and differentiation of benign and malignant vertebral compression fractures. Methods We reviewed respectively 167 patients with a total of 215 vertebral compressive fractures underwent MR examination. There were 98 traumatic fractures, 39 non trauma fractures, and 78 malignant fractures. The following MRI characteristic were investigated: pattern and margin of replaced bone marrow, shape of compressive veterbra, pedicle involvement, paravertebral soft tissue mass, free fragment of bone, and other veterbra involvement. Results The complete marrow replacement (type I) was found in the malignant compression fracture, but the incomplete marrow replacement (type II) and complete marrow preservation (type III) was observed in benign compression fracture ( P <0.001). A well defined margin was seen in the trauma and non trauma, but ill defined margin in malignant ( P <0.001). A wedge shape of vertebra was usually found in trauma and malignant fracture, a reverse shape only in malignancy and a concave shape in benign ( P <0.001). The malignant fracture had a paravertebra soft tissue, pedicle involvement and other vertebral metastases; the benign fracture had a disc tear, narrow or extension of intervertebra space, or free fragment. Conclusion There is some characteristic MRI findings that allow sensitive and specific differentiation of benign and malignant compression fracture.
出处
《中国医学影像技术》
CSCD
2001年第7期626-628,共3页
Chinese Journal of Medical Imaging Technology
