骶骨衰竭骨折MRI研究

目的探讨骶骨衰竭骨折的MR I表现特征及其诊断价值。方法21例病人,女19例,男2例,平均年龄72.4岁。所有病人均有骨质疏松,其中7例为盆腔肿瘤放疗后发病。MR I检查使用矢状位、横轴位和冠状位SE T1W I、FSE T2W I和脂肪抑制FSET2W I。其中14例同时行SE T1W I增强扫描。所有病人均同时行X线平片、CT平扫检查,其中14例行同位素扫描以证实诊断。结果21例共发生37侧骶骨耳部骨折,其中16例(76.2%)为双侧骨折,5例(23.8%)为单侧骨折。37侧骨折中,32侧(86.5%)显示“蛇形”低信号骨折线。所有病例均显示片状或三角形骨折周围水肿区呈长T1长T2异常信号。14例增强扫描,骨折线均无强化,水肿区呈不均匀强化。3例合并其他部位多发性不全骨折。结论MR I诊断骶骨衰竭骨折具有特征性,可显示骨折线及骨折周围水肿区。

Insufficiency Fractures of Sacrum: MR Imaging Study

Objective To evaluate MRI appearancs and its diagnostic value on sacral insufficiency fractures.Methods Sacralinsufficiency fractures in 21 patients(19 females and 2 males,mean age 72.4 years old) with osteoporosis(n=21) and post-radiation for pelvis malignant tumors(n=7) were performed MRI examination with sagittal,axial,and coronal SE T_1WI,FSE T_2WI,and Fat-Sat FSE T_2WI,respectively.Contrast-enhanced SE T_1WI were performed in 14 patients.X-ray plain film(n=21),CT scans(n=21),and bone scans(n=14) were used to confirm each diagnosis of the fractures.Results Thirty-seven fractures of the patients were involved in the sacral alae in 16 cases(76.2%) with bilateral and 5 cases(23.8%) with unilateral.The fracture lines were demonstrated as low signalintensity on all of the sequences in 32 of 37 fractures(86.5%).The edema areas around the fracture lines were long T_1 and long T_2abnormal signal intensity in all of the fractures.The fracture lines and edema areas in 14 patients with contrast-enhancedscans demonstrated without enhancement and with inhomogeneous enhancement respectively.Three of 21 patients had multiple insufficiency fractures in other bones.Conclusion MRI is sensitive and specific in diagnosis of sacral insufficiency fracture.