良恶性多椎体压缩性骨折的MRI诊断

目的:探讨良、恶性多椎体压缩性骨折的MR影像学特征。方法:回顾220例(良性104例,恶性116例)460个压缩椎体,比较病变椎体排列特性及MRI征象。结果:恶性多椎体压缩骨折,椎体跳跃式侵犯多见,66%的病灶集中在椎体后2/3髓质,T1WI呈穿凿样、片状低信号,并椎弓根、椎板表现膨胀性骨质破坏,椎间盘形态正常;良性多椎体压缩性骨折,椎体连续性病变多见,终板表现带状异常信号,常伴椎间盘撕裂、椎间隙狭窄或增宽,椎体碎裂,但无软组织肿块。结论:MR的特征性改变能准确鉴别良、恶性压缩骨折。

MRI differential diagnosis of malignant and benign vertebral compression fracture

Objective:To study the MRI diagnosis and differential diagnosis of malignant and benign vertebral compression fracture.Methods: MR imaging features were retrospectively analyzed in 220 patients(104 metastases,116 benign lesions) with 460 multiple vertebral collapses.The arrangement features and MRI signs of multiple vertebral collapses were compared between the benign lesions and the metastases.Results:The malignant vertebral compression fractures presented as skipped,punched-out or patchy low signal intensity on T1WI,and were mainly located in 2/3 posterior medullary substance in 66% multiple vertebral collapses of metastases.Expansile destruction of bone was observed in the lateral mass and plate of vertebrae,but no disci intervertebral was involved.The benign vertebral compression fractures presented as successional lesions in centrum vertebrae,band-shaped low signal intensity in end plate on T1WI,with laceration of disci intervertebral,stricture or widen of intervertebral space,and body of vertebra broken to pieces without paravertebral soft tissue mass.Conclusion:MR imaging may accurately distinguish the benign from the multiple vertebral collapses of metastases.