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磁共振脂肪抑制 STIR序列在椎体压 缩性骨折中的诊断 价值研究

作者:朱朝选

所属单位:河南省许昌市人民医院CT室 (河南 许昌 461000)

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摘要

目的 探讨磁共振脂肪抑制STIR 序列在椎体压缩性骨折诊断中的临床价 值。方法 收集我院2015年3月-2016年4月 我院收治的经手术或临床病理证实为椎体 压缩性骨折患者42例的影像学资料。所 有研究者均行常规磁共振及磁共振脂肪抑 制STIR序列检查,并阐述磁共振脂肪抑制 STIR序列对椎体压缩性骨折中的临床诊断 价值。结果 42例研究对象中,其中24例 骨折部位为胸椎,18例骨折部位为腰椎, 其中为单个椎体病变的有28例,为多节椎 体病变的有14例;椎体压缩性骨折在MRI 图像上主要呈现凹陷形和扁平形;其中椎 体后缘骨皮质主要表现形态为:骨皮质后 缘上、下角后翘,后缘皮质成角;在T1WI 扫描序列中椎体内呈低信号显示,在T2WI 扫描序列上椎体内呈稍高信号,在脂肪抑 制STIR序列上椎体内显示大部分为高信 号,少数椎体内出现小部分低信号;磁共 振脂肪抑制STIR序列对42例患者的检查结 果均显示为椎体压缩性骨折,磁共振脂肪 抑制STIR序列对椎体压缩性骨折的确诊率 为100%。磁共振脂肪抑制STIR序列扫描对 椎体压缩性骨折的形态、附件及周围软组 织显影均直观清晰。结论 磁共振脂肪抑 制STIR序列对椎体压缩性骨折检出率高, 能从多角度、多切面准确显示椎体压缩骨 折的具体情况,为临床提供了影像学资料 具有重要指导作用。

Objective To investigate the clinical value of magnetic resonance fat suppression STIR sequence in the diagnosis of vertebral compression fractures. Methods The imaging data of 42 patients with vertebral compression fractures confirmed by surgery or clinical pathology in our hospital from March 2015 to April 2016 were collected. All participants underwent conventional MRI and STIR fat suppression sequence checking, and described the MRI fat suppression sequence of STIR vertebral compression fractures in clinical diagnosis. Results 42 cases were studied, including 24 cases of thoracic fracture, 18 cases of fracture site of lumbar spine, including single vertebral body lesions in 28 cases, a plurality of vertebral body lesions in 14 cases. Vertebral compression fractures on the MRI image shows the main concave and flat shape, the posterior cortical bone vertebral main forms: posterior cortical bone of upper and lower corner after Alice, posterior cortex angle; In the T1WI scan sequence, the vertebral body showed a low signal, and a slightly higher signal appeared in the vertebral body on the T2WI scan sequence. In the fat suppressed STIR sequence, most of the vertebral body showed high signal, and a few small signals appeared in the vertebral body. Magnetic resonance fat suppression STIR sequence of 42 patients showed vertebral compression fractures, magnetic resonance fat suppression STIR sequence of vertebral compression fracture diagnosis rate was 100%. Magnetic resonance fat suppression STIR sequence scan of vertebral compression fracture shape, accessories and surrounding soft tissue development is intuitive and clear. Conclusion Magnetic resonance fat suppression STIR sequence has high detection rate of vertebral compression fracture, and can display the specific situation of vertebral compression fracture from multi angle and multi view, which provides important imaging data for clinical guidance.

【关键词】磁共振;脂肪抑制STIR序列; 椎体压缩性骨折;诊断价值

【中图分类号】R274.1

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.06.041

前言

脊柱压缩性骨折是中老年人常见的一种脊柱损伤,其中常见的为 胸腰椎压缩性骨折,一般是指前屈伤力造成椎体前半部(前柱)压缩, 脊椎后部的椎弓(后柱)正常,少数有牵拉伤力损伤[1]。患者进行X线检 查时,由于平片是一种二维图像,仅仅根据楔形变形很难对椎体病变 进行判断,而且该操作对摆位要求极高,患者由于伤痛很难规范其体 位,所以可能导致X线片质量不佳,从而易发生漏诊[2-3]。CT扫描对观 察骨小梁骨折、骨皮质断裂上尚可[4]。MRI通过信号的不同来显示椎弓 损伤,软组织损伤。对骨肿瘤,特别是恶性肿瘤引起的病理骨折,MRI 具有较高的诊断价值[5]。本文为此进行了研究探讨,旨在针对磁共振 脂肪抑制STIR序列椎体压缩性骨折的诊断价值。