MRI在鉴别诊断老年骨质疏松性骨折与转移瘤骨折中的应用价值
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摘要
目的分析MRI在鉴别诊断老年骨质疏松性骨折与转移瘤骨折中的应用。方法回顾性分析我院自2012年1月～2016年12月收治的40例老年骨质疏松性骨折患者及40例转移瘤骨折患者的临床资料,观察两类患者的MRI影像学表现,对比二者之间的差异。结果骨质疏松性骨折患者与转移瘤患者的MRI诊断结果中T2WI低信号及椎体形态改变中的扁平形检出率相比无明显差异(P>0.05)。骨质疏松性骨折患者与转移瘤患者的MRI诊断结果中T1WI低信号、高信号,T2WI高信号及椎体形态改变中的楔形、凹陷形、后缘成角及后缘膨隆检出率相比,差异具有统计学意义(P<0.05)。结论利用MRI鉴别诊断老年骨质疏松性骨折与转移瘤骨折具有重要的应用价值。
Objective To investigate and analyze the application value of MRI on the differential diagnosis between aged osteoporotic fracture and pathologic fracture of metastatic tumor. Methods Clinical records of 40 patients with aged osteoporotic fracture and 40 patients with pathologic fracture of metastatic tumor in our hospital from January2012 to December 2016 were retrospectively analyzed. The radiologic performance of MRI in two kinds of patients was observed and the difference between them was compared. Results There were no significant differences of T2 WI low signal and detection rate of flat shape in the morphological changes of vertebral body between the MRI diagnostic results of patients with osteoporotic fracture and patients with metastatic tumor(P>0.05). There were significant differences of T1 WI low and high signal, T2 WI high signal as well as the detection rates of wedge shape, depression shape, subsequent angle formation and posterior margin swelling in the morphological changes of vertebral body between the MRI diagnostic results of patients with osteoporotic fracture and patients with metastatic tumor(P<0.05). Conclusion The application of MRI in the differential diagnosis between aged osteoporotic fracture and pathologic fracture of metastatic tumor is significantly valuable.
Objective To investigate and analyze the application value of MRI on the differential diagnosis between aged osteoporotic fracture and pathologic fracture of metastatic tumor. Methods Clinical records of 40 patients with aged osteoporotic fracture and 40 patients with pathologic fracture of metastatic tumor in our hospital from January2012 to December 2016 were retrospectively analyzed. The radiologic performance of MRI in two kinds of patients was observed and the difference between them was compared. Results There were no significant differences of T2 WI low signal and detection rate of flat shape in the morphological changes of vertebral body between the MRI diagnostic results of patients with osteoporotic fracture and patients with metastatic tumor(P>0.05). There were significant differences of T1 WI low and high signal, T2 WI high signal as well as the detection rates of wedge shape, depression shape, subsequent angle formation and posterior margin swelling in the morphological changes of vertebral body between the MRI diagnostic results of patients with osteoporotic fracture and patients with metastatic tumor(P<0.05). Conclusion The application of MRI in the differential diagnosis between aged osteoporotic fracture and pathologic fracture of metastatic tumor is significantly valuable.
引文
[1]程凤燕,刘国瑞.骨质疏松与转移瘤所致椎体压缩性骨折的MRI鉴别诊断[J].中国临床医学影像杂志,2012,23(9):90-91.
[2]詹孔才,邹艳.MRI对椎体转移瘤与骨质疏松压缩性骨折鉴别诊断的价值[J].中国当代医药,2012,19(24):23-24.
[3]李翔,张树桐,王翔,等.骨质疏松或骨转移瘤致椎体压缩性骨折患者的MRI鉴别研究[J].吉林医学,2017,38(1):44-45.
[4]欧阳超,陈志明,马华松.椎体后凸成形术治疗骨质疏松椎体压缩骨折术后非手术椎体新发骨折的相关因素分析[J].中国脊柱脊髓杂志,2013,15(3):222-223.
[5]徐妍妍,邹海波,绳厚福.X线、CT、MRI在评估症状性骨质疏松椎体压缩骨折手术治疗中的价值[J].中华医学杂志,2014,15(11):832-833.
[6]田笑笑,张晓强,李同森.经皮椎体成形术与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较研究[J].中国全科医学,2013,15(14):1629-1630.
[7]葛旭,王绪.骨质疏松与转移瘤所致骨折MRI诊断与鉴别诊断[J].影像技术,2016,28(1):90-91.
[8]郭宝英,朱魏,赵太茂.原发性骨质疏松椎体压缩性骨折的X线、MRI影像诊断价值分析[J].中国CT和MRI杂志,2016,14(11):123-124.
[9]夏群,鞠云鹤,龙清,等.腰椎骨转移癌常规与适形放射治疗的疗效与副反应比较[J].云南医药,2010,(5):537-539.
[10]邹子仪.扩散加权成像对椎体骨折性质的鉴别[J].临床医学工程,2016,23(3):123-124.
[11]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):56-57.
[12]裴敏,王琨,裴昌军.中老年胸腰椎压缩性骨折MRI诊断价值[J].现代医用影像学,2015,24(3):167-168.
[13]张薇,梁伟,过哲,等.MR弥散加权成像和化学位移成像对骨质疏松与转移瘤所致椎体压缩骨折的诊断价值[J].现代中西医结合杂志,2017,26(3):23-24.
[14]Murthy NS.Imaging of stress fractures of the spine[J].Radiologic Clinics of North America,2012,50(4):799-821.
[15]赵宇驰,孙常太.X线与磁共振成像对骨质疏松性脊柱压缩骨折诊断的比较[J].中华老年多器官疾病杂志,2012,11(10):788-790.
[16]胡翼江,徐正道,张同华,等.对比分析磁共振化学位移成像与扩散加权成像对良恶性椎体骨折的鉴别诊断价值[J].临床放射学杂志,2015,34(6):955-959.
[17]蔡玖明,吴永峻.MRI扩散加权成像(DWI)在单发椎体良恶性骨折中的鉴别价值[J].齐齐哈尔医学院学报,2013,34(8):1114-1116.
[18]代刚,顾勇.浅析骨质疏松或骨转移瘤致椎体压缩性骨折患者的MRI鉴别研究[J].医药前沿,2016,6(7):213-214.
[19]曾旭,董国礼,周芷溪.ADC值在鉴别脊椎良恶性压缩骨折中的价值[J].中国CT和MRI杂志,2012,10(5):82-85.
[2]詹孔才,邹艳.MRI对椎体转移瘤与骨质疏松压缩性骨折鉴别诊断的价值[J].中国当代医药,2012,19(24):23-24.
[3]李翔,张树桐,王翔,等.骨质疏松或骨转移瘤致椎体压缩性骨折患者的MRI鉴别研究[J].吉林医学,2017,38(1):44-45.
[4]欧阳超,陈志明,马华松.椎体后凸成形术治疗骨质疏松椎体压缩骨折术后非手术椎体新发骨折的相关因素分析[J].中国脊柱脊髓杂志,2013,15(3):222-223.
[5]徐妍妍,邹海波,绳厚福.X线、CT、MRI在评估症状性骨质疏松椎体压缩骨折手术治疗中的价值[J].中华医学杂志,2014,15(11):832-833.
[6]田笑笑,张晓强,李同森.经皮椎体成形术与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较研究[J].中国全科医学,2013,15(14):1629-1630.
[7]葛旭,王绪.骨质疏松与转移瘤所致骨折MRI诊断与鉴别诊断[J].影像技术,2016,28(1):90-91.
[8]郭宝英,朱魏,赵太茂.原发性骨质疏松椎体压缩性骨折的X线、MRI影像诊断价值分析[J].中国CT和MRI杂志,2016,14(11):123-124.
[9]夏群,鞠云鹤,龙清,等.腰椎骨转移癌常规与适形放射治疗的疗效与副反应比较[J].云南医药,2010,(5):537-539.
[10]邹子仪.扩散加权成像对椎体骨折性质的鉴别[J].临床医学工程,2016,23(3):123-124.
[11]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):56-57.
[12]裴敏,王琨,裴昌军.中老年胸腰椎压缩性骨折MRI诊断价值[J].现代医用影像学,2015,24(3):167-168.
[13]张薇,梁伟,过哲,等.MR弥散加权成像和化学位移成像对骨质疏松与转移瘤所致椎体压缩骨折的诊断价值[J].现代中西医结合杂志,2017,26(3):23-24.
[14]Murthy NS.Imaging of stress fractures of the spine[J].Radiologic Clinics of North America,2012,50(4):799-821.
[15]赵宇驰,孙常太.X线与磁共振成像对骨质疏松性脊柱压缩骨折诊断的比较[J].中华老年多器官疾病杂志,2012,11(10):788-790.
[16]胡翼江,徐正道,张同华,等.对比分析磁共振化学位移成像与扩散加权成像对良恶性椎体骨折的鉴别诊断价值[J].临床放射学杂志,2015,34(6):955-959.
[17]蔡玖明,吴永峻.MRI扩散加权成像(DWI)在单发椎体良恶性骨折中的鉴别价值[J].齐齐哈尔医学院学报,2013,34(8):1114-1116.
[18]代刚,顾勇.浅析骨质疏松或骨转移瘤致椎体压缩性骨折患者的MRI鉴别研究[J].医药前沿,2016,6(7):213-214.
[19]曾旭,董国礼,周芷溪.ADC值在鉴别脊椎良恶性压缩骨折中的价值[J].中国CT和MRI杂志,2012,10(5):82-85.