新鲜骨质疏松椎体压缩骨折磁共振T2WI信号改变及其相关因素Change of magnetic resonance T2WI signal and its influence factors in acute osteoporotic vertebral compression fractures
郭惠智;张顺聪;袁凯;莫国业;唐永超;郭丹青;梁德;李永贤;李大星;罗培杰;
摘要(Abstract):
[目的]探讨新鲜骨质疏松椎体压缩骨折(骨折时间≤30 d)磁共振(magnetic resonance imaging,MRI)T2WI信号改变及其可能的影响因素。[方法]回顾性分析本院2013年4月~2016年1月确诊为新鲜OVCFs且影像资料完整的患者164例184椎,男26例,女138例,年龄52~91岁,腰椎骨密度T=(-2.5)~(-5.9),骨折时间2h~30 d,颈椎1个,胸椎82个,腰椎101个,由2名MRI阅片医师分别独立阅片,根据T2WI上信号改变,分为低信号组和高信号组,分别记录两组患者的性别、年龄、骨折时间、受伤史、骨密度、骨折节段及椎体压缩程度,分析上述因素与T2WI低信号的相关性。[结果]新鲜OVCFs在T2WI上大多数呈低信号,单因素二元回归分析显示:性别、年龄、骨折时间与T2WI低信号有关,纳入多因素二元logistic回归分析后,结果提示性别、年龄、骨折时间与T2WI低信号密切相关(P<0.05)。[结论]新鲜OVCFs在磁共振T2WI上主要表现为低信号而不是通常认为的高信号,其低信号与性别、年龄、骨折时间存在一定相关性,女性、高龄、骨折时间较长在T2WI上更可能表现为低信号,但其原因、临床意义仍有待进一步研究。
关键词(KeyWords): 新鲜骨质疏松椎体压缩骨折;T2WI;低信号
基金项目(Foundation): 广东省自然科学基金项目(编号:2016A030313641);; 广东省科技厅项目(编号:2016A020215137)
作者(Author): 郭惠智;张顺聪;袁凯;莫国业;唐永超;郭丹青;梁德;李永贤;李大星;罗培杰;
Email:
DOI:
参考文献(References):
- [1]施庭芳.脊椎压缩性骨折的影像学诊断[J].中华放射学杂志,1999,9(1):62-65
- [2]陈文静,燕桂新,孙亮,等.128排螺旋CT及MRI对诊断骨质疏松性椎体压缩的诊断价值比较[J].中国CT和MRI杂志,2012,10(6):97-99.
- [3]Piazzolla A,Solarino G,Lamartina C,et al.Vertebral bone marrow edema(VBME)in conservatively treated acute vertebral compression fractures(VCFs):evolution and clinical correlations[J].Spine(Phila Pa 1976),2015,40(14):E842-848.
- [4]杨明亮,洪毅,李建军,等.新鲜与陈旧骨质疏松性椎体骨折的鉴别诊断[J].中国矫形外科杂志,2008,165(12):897-899,903.
- [5]Genant HK,Wu CY,van Kuijk C,et al.Vertebral fracture assessment using a semiquantitative technique[J].J Bone Miner Res,1993,8(9):1137-1148.
- [6]Ahn SE,Ryu KN,Park JS,et al.Early bone marrow edema pattern of the osteoporotic vertebral compression fracture:can be predictor of vertebral deformity types and prognosis[J].J Kor NeurosurgSoc,2016,59(2):137-142.
- [7]王晨,程克斌,蒋雯,等.多发骨质疏松性椎体的急性或亚急性骨折的MRI表现[J].中国骨质疏松杂志,2012,18(11):975-979.
- [8]刘玥,周博,匡永才,等.老年骨质疏松性椎体压缩性骨折患者急性期MRI信号与经皮椎体后凸成形术后效果的相关性[J].中国老年学杂志,2016,36(23):5945-5947.
- [9]Takahashi S,Hoshino M,Takayama K,et al.Time course of osteoporotic vertebral fractures by magnetic resonance imaging using a simple classification:a multicenter prospective cohort study[J].Osteoporos Int,2017,28(2):473-482.
- [10]Kazawa N.T2WI MRI and MRI-MDCT correlations of the osteoporotic vertebral compressive fractures[J].Eur J Radiol,2012,81(7):1630-1636.
- [11]Baur A,St?bler A,Arbogast S,et al.Acute osteoporotic and neoplastic vertebral compression fractures:fluid sign at MR imaging[J].Radiology,2002,225(3):730-735.
- [12]Linn J,Birkenmaier C,Hoffmann RT,et al.The intravertebral cleft in acute osteoporotic fractures:fluid in magnetic resonance imaging-vacuum in computed tomography[J].Spine(Phila Pa 1976),2009,34(2):E88-93.
- [13]Yu CW,Hsu CY,Shih TT,et al.Vertebral osteonecrosis:MR imaging findings and related changes on adjacent levels[J].AJNR Am J Neuroradiol,2007,28(1):42-47.
- [14]Kim DY,Lee SH,Jang JS,et al.Intravertebral vacuum phenomenon in osteoporotic compression fracture:report of 67 cases with quantitative evaluation of intravertebral instability[J].J Neurosurg,2004,100(1 Suppl Spine):24-31.
- [15]李联忠,冯卫华,王国华,等.脊椎疾病影像诊断学[M].2版.北京:人民卫生出版社,2015:52-53.
- [16]丁建平,肖江喜,范晓颖.正常腰椎骨髓MRI信号观察[J].中国医学影像技术,2003,16(1):76-78.
- [17]Diamond TH,Clark WA,Kumar SV.Histomorphometric analysis of fracture healing cascade in acute osteoporotic vertebral body fractures[J].Bone,2007,40(3):775-780.
- [18]毛小峰,张晓,程军,等.腰椎骨髓信号在高、低场磁共振的对比[J].医学影像学杂志,2014,12(12):2151-2153,2157.