摘要
目的观测探讨老年骨质疏松性椎体压缩骨折并发缺血坏死不愈合的影像学表现。方法 45例骨质疏松性压缩骨折并发缺血坏死不愈合病例,20例经X线平片和CT检查,24例仅摄X线片,1例仅作CT检查,对所有X线平片及CT影像进行回顾分析。结果 44例49个椎体的X线平片测量,最大压缩比(病变椎体最薄部位厚度与相邻椎体对应部位厚度均值之比)为24.2%±7.0%,楔变比为39.1%±8.7%,所有病变椎体的最大压缩比均少于1/3。根据病变椎体X线平片是否见到椎体"真空现象",49个椎骨分为两个类型:(1)吸收压缩型,21例25个椎体,主要表现为椎体明显吸收压缩,密度不均匀;(2)假关节不愈合型,24例24个椎体,主要表现为椎体内存在裂隙,骨折不愈合,椎体两部分间有假关节形成。21例经CT扫描患者,共26个椎体内见到该病变的所谓特征表现"真空现象",气体多位于椎体裂隙内,其中的11个椎体在X线平片未见明显气体。结论老年骨质疏松性椎体压缩骨折并发缺血坏死和骨折不愈合,除了椎体内"真空征象"以外,有多项影像学表现对该病症的诊断有重要价值。
Objective To observe and explore the imaging features of the complication of vertebral compression fractures （VCF） , avascular necrosis and nonunion, in the elderly with osteoporosis. Methods Retrospective analysis of 45 cases of patients with VCF complicated with avascular necrosis and nonunion was performed, 20 cases of them with X-ray and CT examination, 24 cases with X-ray photography only, and 1 case with CT examination only. Results The maximum compression ratio （the ratio of the thinnest part of the vertebral lesion and the average thickness of adjacent vertebral body） was 24.2 ~ 7.0% in 49 vertebral X-ray plain films of the 44 cases. The wedge variability was 39. 1 ＋ 8.7%. The maximum compression ratio of all lesions was less than one third. According to the pathological vacuum phenomenon showing in the vertebral body in X-ray plain films, 49 vertebrae were divided into two types. The absorption and compression type was characterized by obvious absorption compressed vertebral bodies and uneven density showing in 25 vertebral bodies of 21 cases. The pseudarthrosis nonunion type was characterized by fracture clefts and nonunion and abnormal activities between two parts of the vertebral body showing in 24 vertebral bodies of 24 cases. The vacuum phenomenon was seen in 26 see the vertebral body lesions of 21 patients using CT scan. The air mostly located inside the vertebral fracture clefts, which was not seen in 11 vertebral bodies in X-ray plain films. Conclusion More imaging findings have the important value for the diagnosis of complications of avascular necrosis and nonunion of VCF in the elderly with osteoporosis in addition to the vertebral body sign of vacuum.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2015年第3期318-322,共5页
Chinese Journal of Osteoporosis
关键词
老年人
椎体压缩骨折
骨质疏松症
缺血坏死
不愈合
影像诊断
The elderly
Vertebral Compression fractures （VCF）
Osteoporosis
Ischemic necrosis
Nonunion
Imaging diagnosis
