低场强MRI对胸腰椎新旧压缩性骨折的鉴别诊断价值(1)
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[摘要] 目的：探讨胸腰椎新旧压缩性骨折的低场强MRI影像表现和鉴别诊断价值。方法：对X光诊断并临床证实80例(102个)胸腰椎体压缩患者的低场强MRI表现进行回顾性分析。结果：新鲜压缩性骨折椎体的MRI表现如下，椎体呈楔形、扁平形、凹陷形压缩变形；椎体呈带状、片状异常信号，T1W呈低信号，T2W等高混杂信号，T2W抑脂呈高信号；陈旧压缩性骨折椎体形态改变与新鲜的相似，椎体信号同临近正常椎体相仿，T1W呈偏高信号，T2W呈等信号，T2W抑脂呈偏低信号。结论：低场强MRI检查对新旧压缩性骨折有较高的敏感性和特异性，对新旧压缩性骨折的鉴别诊断有重要的价值。
[关键词] 骨折；胸椎；腰椎；低场强；磁共振成像
[中图分类号]R445.2[文献标识码] C[文章编号] 1673-7210(2009)05(a)-106-03
The value of differential diagnosis of low-field MRI to the new and the old thoracic and lumbar compression fracture
ZHUANG Weixiong, LONG Xiaowu, WEN Haizhong, ZHU Zhichang, HAO Jingjun
(Department of CT MRI, Yunfu People's Hospital, Yunfu 527300, China)
[Abstract] Objective: To explore the appearance and the value of differential diagnosis, of the low-field MRI of the new and the old thoracic and lumbar compression fracture. Methods: The low-field MRI appearances of thoracic and lumbar compression fracture of 80 cases (102 patients) which were diagnosed by X-ray and confirmed through clinic were analyzed retrospectively. Results: The MRI appearances of the new vertebral compression fracture were as follows: the compressive deformation of vertebrae presented wedge, flat and saucer type; the vertebrae presented banded and lamellar abnormal signal: the lesions were hypointense on SET1W, isointense and hyperintense mixed signal on SET2W and hyperintense on STIRT2W. The old vertebral compression fracture were similar to the new ones. The vertebral signals were similar to the near normal vertebrae: the lesions were partial hyperintense on SET1W, isointense on SET2W and partial hypointense on STIRT2W. Conclusion: The examination of low-field mri has higher sensitivity and specificity to the new and the old compression fracture, and there are important value from differential diagnosis to the new and the old compression fracture.
[Key words] Fractures; Thoracic; Lumbar; Low field; Magnetic resonance imaging
外伤是造成脊柱压缩性骨折的主要原因，其中车祸伤、工伤较为常见；脊柱新旧压缩性骨折关系着治疗方案的制定、受伤患者和肇事者(负责人)的赔偿问题和法律责任，所以对脊柱新旧压缩性骨折的鉴别诊断准确性的要求越来越高，由于X线检查的局限性，而MRI检查对脊柱外伤有特异性影像表现 ......
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