多发椎体压缩骨折良恶性MRI鉴别诊断

目的MRI鉴别多发椎体良恶性压缩骨折。方法171个椎体压缩骨折（良性77个、恶性94个），16个经椎体活检，其余经3～6个月MRI追踪确诊。行T

Multiple VertebralCompression Fracture:Benign and Malignant MRI Differential Diagnosis

Objective　To distinguish benign from malignant multiple vertebral collapses.Methods　171 vertebral collapses (77 benign,94 malignancy) were studied in 58 patients with T1WI,T2/T2WI,contrast enhancement T1WI with fat saturation.Pathologic result was available in 16 vertebras,including 10 malignancy and 6 benign.The remaining patients were performed 3～6 months follow-up to confirm the final diagnosis.The following MR characteristics were reviewed:(1)The shape and distribution of abnormal signal intensity.(2)The shape of antero-or poster-border of compressive vertebral body.(3)Paravertebral soft tissue mass.(4)The change of lesions signal intensity on T1WI,T2WI and contrast enhanced MRI with fat saturation.(5)Signal intensity increasing ratio after contrast enhancement.Results　The malignant vertebral compression fractures showed as the punch or patchy low signal intensity on T1WI distributing anywhere in the compressive body and enhancement.It had the convex posterior cortex,pedicle involved,paravertebral soft tissue mass.The benign vertebral compression fractures showed as the band linear hypo-or-iso-intensity in end-plate,enhanced (acute fracture)or unenhanced(old fracture),retropulsion of posterior cortex,no pedicle involved and paravertebral soft tissue.Conclusion　The most important MR characteristics for differentiation of malignant or bengin vertebral compression are the shapes and distributions of the abnormal signal intensities of vertebral collapses.The contrast enhancement T1WI with fat saturation is helpful for imaging diagnosis.