【摘要】 目的分析骨质疏松椎体压缩骨折不同时期磁共振（MRI）信号改变特征及其临床意义。方法选择骨质疏松椎体压缩骨折患者行磁共振影像检查,并与X线影像对比,对骨折后24个月内MRI信号变化特征进行分析,探讨其临床意义。结果发生骨质疏松骨折椎体内MRI信号变化特征:T₁WI低信号、T₂WI高信号、T₂WI+FS信号进一步增高,信号伴随整个骨折发生、临床愈合及愈合后修复重建过程,在骨折后6个月内均出现信号变化。一般在6¹2个月修复重建结束后椎体内磁共振信号逐渐恢复为T₁WI等信号、T₂WI等信号、T₂WI+FS等信号。骨折后12²4个月磁共振信号完全恢复正常。与X线比较,磁共振可通过信号变化特征反应椎体内骨折发生、愈合及修复重建过程,推测骨折时间。临床上可区分新鲜骨折及陈旧骨折,可对X线检查无法早期发现的骨挫伤、隐匿性骨折及跳跃性骨折做出早期诊断。结论椎体内磁共振信号变化反映了骨折发生、愈合及修复重建变化,有利于揭示椎体内松质骨骨折病理生理过程;可提高隐匿性椎体骨折、跳跃性椎体骨折诊断准确率,避免误诊、漏诊;对已变形椎体可提示椎体骨折时间,是否引起临床症状,有利于诊断、治疗方案制订及指导治疗及康复进程。磁共振作为一种可靠的影像学工具有利于骨质疏松椎体压缩骨折诊断和治疗。更多还原

【Abstract】 Objective To analyze the variation characteristics and clinical significance of magnetic resonance imaging（MRI） signals in osteoporotic vertebral compression fractures（OVCF） in different periods.Methods The patients with OVCF underwent the MRI examination,and the results were compared with that of the X-ray examination.The variation characteristics of MRI signals in 24 months after OVCF were analyzed,and the clinical significance was investigated.Results The variation characteristics of MRI signals in the osteoporotic fractured vertebral body were stated as follows.Low signals in T₁WI,high signals in T₂WI and further higher signals in T₂WI+FS were found.Signals were noted during the whole process of fracture occurrence,clinical healing,repair and reconstruction,and no signal changes were found in 6 months after OVCF.In 6-12 months after the repair and reconstruction,MRI signals in the vertebral body gradually recovered to normal signals in T₁WI,T₂WI and T₂WI+FS.In 12-24 months after OVCF,MRI signals completely recovered to the normal level.Comparing with the X-rays,the occurrence,healing,repair and reconstruction of fractures in the vertebral body could be indicated by the variation characteristics of MRI signals,and the fracture time could be speculated.Fresh fractures and old fractures could be differentiated clinically,and early diagnosis could be made for bone contusions,obscure fractures and discontinuous fractures,which could not be easily found by the X-ray examination.Conclusions The changes of MRI signals in the vertebral body indicate the change of the occurrence,healing,repair and reconstruction of fractures,which will help to reveal the pathophysiological procedure of osteoporotic vertebral fractures.The accurate rate can be improved in the diagnosis of obscure vertebral fractures and discontinuous vertebral fractures,so as to avoid the misdiagnose and missed diagnosis.As to the deformed vertebral bodies,the vertebral fracture time can be pointed out,so can the clinical symptoms,which will help to make the plan of diagnosis and treatment and guide the treatment and rehabilitation.As a reliable imaging tool,MRI promotes the diagnosis and treatment of OVCF.更多还原