骨质疏松与转移瘤所致急性椎体压缩的MRI鉴别诊断

目的 分析、总结骨质疏松与转移瘤所致的急性椎体压缩的MRI表现，评估MRI在两者鉴别诊断中的价值。材料与方法 根据临床表现、生化检查、普通X线照片及CT检查等随机选择骨质疏松及转移瘤各30例，每例均同时进行SE、T1W、FSE、T2W及SE、T1W增强检查。结果 总结了有助于急性椎体压缩鉴别诊断的11种MRI表现：提示为骨质疏松所致的有4种，其中压缩椎体后缘向前成角且骨片向椎管内突出为特异性表现；提示为转移瘤的有7种，其中硬膜外肿块、椎弓根骨质破坏、T1W增强扫描及T2WI呈弥漫性高信号或非均匀性信号为特征性表现。结论 在鉴别是骨质疏松还是转移瘤所致的急性椎体压缩中，MRI是一种敏感和可靠的检查方法。

Differential Diagnosis of Acute Vertebral Collapse Due to Osteoprosis or Metastasis Tumor in MRI

Objective To analyze and sum up the MRI appearances of osteoporotic acute vertebral collapse(OAVC) or metastatic acute vertebral collapse(MAVC) and evaluate MRI value in both the differential diagnosis .Methods 30 cases of OAVC and 30 cases of MAVC were respectively collected at random according to clinical features,biochemical examinations,conventional radiograghy,and CT scan and all cases were studied with SE,T1-weighted images,gadolinium-enhanced T1-weighted images,and SE,T2-weighted images.Results 11 MRI apperances which were valuable in distinguishing OAVC from MAVC were summed up.Four images suggested that it was OAVC,one of which was specific:retropulsion of a bone fragment of collapsed vertebral body into the spinal canal.Seven images suggested MAVC,four of which were specific:dull-bell shaped body,destruction of pedicles,epidural mass,diffuse high or inhomogeneous signal intensity within the vertebral body on gadninium-enhenced T1-weighted images and T2-weighted images.Conclusion MRI is very useful in the differentiating OAVC from MAVC.