摘要
目的分析X线、CT和MRI多模态影像对溶骨性转移瘤和骨质疏松致椎体压缩性骨折的诊断价值。方法回顾性分析浙江省中医药大学附属江南医院(萧山区中医院)2019年1月至2021年5月102例椎体压缩性骨折患者的基础临床资料及X线、CT、MRI影像学数据。其中,溶骨性转移瘤致椎体压缩性骨折47例,骨质疏松致椎体压缩性骨折55例。结果溶骨性转移瘤致椎体压缩性骨折患者年龄和骨质疏松率明显低于骨质疏松致椎体压缩性骨折患者[(61.95±11.84)岁比(72.37±12.55)岁和4.3%(2/47)比83.6%(46/55)],体质量指数和疼痛视觉模拟评分明显高于骨质疏松致椎体压缩性骨折患者[(22.58±3.85)kg/m2比(18.11±2.79)kg/m2和(8.31±2.91)分比(7.02±2.72)分],差异均有统计意义(P<0.05);两者性别构成比较差异无统计学意义(P>0.05)。溶骨性转移瘤致椎体压缩性骨折椎体形态楔形和双凹形率明显低于骨质疏松致椎体压缩性骨折[2.80%(3/107)比60.82%(104/171)和6.54%(7/107)比29.82%(51/171)],扁平形和后缘膨隆率明显高于骨质疏松致椎体压缩性骨折[75.70%(81/107)比9.36%(16/171)和14.95%(16/107)比0],差异有统计学意义(P<0.01);溶骨性转移瘤致椎体压缩性骨折椎弓根受累和软组织肿块率明显高于骨质疏松致椎体压缩性骨折[68.09%(32/47)比1.82%(1/55)和46.81%(22/47)比0],而椎体内线性影像信号率明显低于骨质疏松致椎体压缩性骨折[0比96.36%(53/47)],差异有统计学意义(P<0.01);两者椎体MRI信号比较差异有统计学意义(P<0.01),溶骨性转移瘤致椎体压缩性骨折以低T1高T2和低T1低T2为主,骨质疏松致椎体压缩性骨折以低T1高T2为主;溶骨性转移瘤致椎体压缩性骨折椎间盘压缩和增宽率明显低于骨质疏松致椎体压缩性骨折[4.26%(2/47)比34.55%(19/55)和2.13%(1/47)比18.18%(10/55)],差异有统计学意义(P<0.01或<0.05)。多模态影像诊断溶骨性转移瘤致椎体压缩性骨折和骨质疏松致椎体压缩�
Objective To analyze the diagnostic value of X-ray,CT and MRI multimodal images in the vertebral compression fractures caused by osteolytic metastases and osteoporosis.Methods The basic clinical data and X-ray,CT,MRI imaging data of 102 patients with vertebral compression fractures from January 2019 to May 2021 in Jiangnan Hospital(Xiaoshan Traditional Chinese Medicine)Affiliated to Zhejiang University of Traditional Chinese Medicine were retrospectively analyzed.Among them,vertebral compression fractures caused by osteolytic metastases was in 47 cases,and vertebral compression fractures caused by osteoporosis was in 55 cases.Results The age and osteoporosis rate in patients with vertebral compression fractures caused by osteolytic metastases were significantly lower than those in patients with vertebral compression fractures caused by osteoporosis:(61.95±11.84)years old vs.(72.37±12.55)years old and 4.3%(2/47)vs.83.6%(46/55),the body mass index and pain visual analogue score were significantly higher than those in patients with vertebral compression fractures caused by osteoporosis:(22.58±3.85)kg/m2 vs.(18.11±2.79)kg/m2 and(8.31±2.91)scores vs.(7.02±2.72)scores,and there were statistical differences(P<0.05);there was no statistical difference in gender composition(P>0.05).The rates of vertebral body wedge shape and double concave shape in patients with vertebral compression fractures caused by osteolytic metastases were significantly lower than those in patients with vertebral compression fractures caused by osteoporosis:2.80%(3/107)vs.60.82%(104/171)and 6.54%(7/107)vs.29.82%(51/171),the rates of flat shape and posterior margin swelling were significantly higher than those in patients with vertebral compression fractures caused by osteoporosis:75.70%(81/107)vs.9.36%(16/171)and 14.95%(16/107)vs.0,and there were statistical differences(P<0.01);the rates of pedicle involvement and soft tissue mass in patients with vertebral compression fractures caused by osteolytic metastases were significantly higher than t
作者
王海姣
倪水军
徐亦生
Wang Haijiao;Ni Shuijun;Xu Yisheng(Department of Radiology,Jiangnan Hospital(Xiaoshan Traditional Chinese Medicine)Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou 311200,China)
出处
《中国医师进修杂志》
2022年第11期997-1003,共7页
Chinese Journal of Postgraduates of Medicine
基金
浙江省医药卫生科技计划(2019KY548)。
关键词
骨折
压缩性
脊柱骨折
骨质疏松症
诊断
鉴别
溶骨性转移瘤
Fractures,compression
Spinal fractures
Osteoporosis
Diagnosis,differential
Osteolytic metastases
