新鲜与陈旧骨质疏松性椎体骨折的鉴别诊断Differential diagnosis of acute from chronic osteoporotic vertebral fractures
杨明亮;洪毅;李建军;徐建民;唐和虎;李想;
摘要(Abstract)：
[目的]总结新鲜与陈旧骨质疏松性椎体骨折的鉴别要点。[方法]分析骨质疏松性椎体骨折病人的临床及影像学特点。[结果]36例骨质疏松性椎体骨折中,诊断为新鲜骨折23例(64%),陈旧骨折13例(36%)。椎体前高降低(或楔形变)是骨质疏松性椎体骨折最主要的影像学表现。在X线片、CT上,陈旧的骨折椎,常有终板硬化、骨质增生;新鲜骨折椎,可观察到骨折线。在核磁共振检查上,新鲜骨折椎表现为T2高信号,T2脂肪抑制相高信号。67%的骨质疏松性椎体骨折,可以通过病史、临床表现及X线片,鉴别出新鲜或陈旧骨折;33%病例,需通过核磁共振检查进行鉴别。[结论]椎体楔形变基础上伴骨硬化、骨质增生,提示陈旧骨质疏松性椎体骨折;有外伤史,伤后胸、腰背疼痛,且局部叩、压痛与影像检查发现的骨折水平相符时,应高度怀疑新鲜骨折;从X线片或CT上观察到清晰的骨折线,核磁共振上观察到T2脂肪抑制相高信号,可确认为新鲜骨折。
关键词(KeyWords)： 骨质疏松性椎体骨折;骨质疏松;新鲜骨折;陈旧骨折
基金项目(Foundation):
作者(Author): 杨明亮;洪毅;李建军;徐建民;唐和虎;李想;
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参考文献(References)：
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