MR成像在单椎体塌陷性病变鉴别诊断中的应用

目的描述骨折或骨转移所致单椎体塌陷性病变的MRI表现,探讨其鉴别诊断价值.方法对33例单椎体塌陷性病变行MR检查,其中29例临床证实,4例穿刺活检证实,良性13例,恶性20例,分析其MRI表现.结果与良性病变相比,恶性者常伴瘤周水肿,边界模糊,受累椎体鲜有残存骨髓影,受侵附件多呈膨胀性改变,常伴椎旁软组织影,强化欠均匀,追随观察病灶增大变多或无明显改变.结论 MRI能较好鉴别单椎体塌陷性病变的良恶性.

Differentiation of benign and malignant solitary vertebral collapse using MR imaging

Objective To describe the MRI manifestations of solitary vertebral collapse (SCV) caused by benign compression fracture or malignant bone metastases, and to discuss the MR diagnostic value in this diseases entity. Methods Total 33 cases, 29 clinically follow up proved and 4 pathologically biopsy proved of SCV were analyzed. There were 13 cases of benign compression fractures caused by senile osteoporosis and 20 resulted from metastases pathologic fracture. Results Compared with benign SVC, MR imaging of malignant SVC demonstrated poorly defined margin of the intravertebral lesion due to the paralesional edema, seldom remained fat of the vertebral body, often pedicle involvement with expanded contour, some with obvious paravertebal soft tissue and inhomogeneous enhancement. Follow up MR imaging showed enlargment in size or increase in number of the lesions, or without changes after therapy. Conclusion MRI is helpful to differentiate benign from malignant causes of SCV.