CAJ | 학술논문

目的探讨多层螺旋CT(MSCT)扫描及重组技术和MRI在鉴别新旧胸腰椎压缩性骨折中的应用价值.方法对167例新旧胸腰椎压缩性骨折患者共189个椎体进行MSCT检查,图像资料经工作站处理进行二维和三维重组,并对34例患者的43个椎体行MRI,将2种方法所得图像进行比较分析.结果在新鲜与陈旧椎体压缩性骨折中,其椎体数均以L1占比例最高,分别是27.68%(31/112)和35.06%(27/77),其次为T12、L2和T11.在新鲜与陈旧胸腰椎压缩性骨折CT表现中,骨折线清晰锐利(分别为102和21个椎体)、脊髓挫伤出血(分别为15和0个椎体)、脊椎旁软组织影(分别为103和11个椎体)、附件骨折(分别为26和5个椎体)、椎体周围脏器挫裂伤(分别为30和0个椎体)、椎间盘真空征(分别为10和36个椎体)、椎体骨小梁结构紊乱硬化(分别为29和51椎体)等征象,经χ2检验差异均有统计学意义(P值均＜0.01).新鲜骨折共21例27个椎体,其中有26个在MRI中呈不均匀T1WI低信号,27个椎体在T2WI抑脂序列中呈不规则高信号.而在13例陈旧性骨折患者中,有16个椎体在T1WI和T2WI中的信号均与正常椎体相同,16个椎体在T2WI抑脂序列中呈低信号.结论 MSCT扫描在鉴别大多数新旧胸腰椎压缩性骨折中发挥着重要作用,而MRI诊断脊髓及韧带损伤可反映病理生理表现.因此,MSCT及其重组技术与MRI在鉴别诊断中结合应用可大大提高诊断的准确性.
목적 탐토다층라선CT(MSCT)소묘급중조기술화MRI재감별신구흉요추압축성골절중적응용개치.방법 대167례신구흉요추압축성골절환자공189개추체진행MSCT검사,도상자료경공작참처리진행이유화삼유중조,병대34례환자적43개추체행MRI,장2충방법소득도상진행비교분석.결과 재신선여진구추체압축성골절중,기추체수균이L1점비례최고,분별시27.68%(31/112)화35.06%(27/77),기차위T12、L2화T11.재신선여진구흉요추압축성골절CT표현중,골절선청석예리(분별위102화21개추체)、척수좌상출혈(분별위15화0개추체)、척추방연조직영(분별위103화11개추체)、부건골절(분별위26화5개추체)、추체주위장기좌렬상(분별위30화0개추체)、추간반진공정(분별위10화36개추체)、추체골소량결구문란경화(분별위29화51추체)등정상,경χ2검험차이균유통계학의의(P치균＜0.01).신선골절공21례27개추체,기중유26개재MRI중정불균균T1WI저신호,27개추체재T2WI억지서렬중정불규칙고신호.이재13례진구성골절환자중,유16개추체재T1WI화T2WI중적신호균여정상추체상동,16개추체재T2WI억지서렬중정저신호.결론 MSCT소묘재감별대다수신구흉요추압축성골절중발휘착중요작용,이MRI진단척수급인대손상가반영병리생리표현.인차,MSCT급기중조기술여MRI재감별진단중결합응용가대대제고진단적준학성.
Objective To analyze and explore the value of the mutislice spiral CT (MSCT) scanning,its reconstructive technology and MRI scanning for applying to the identifying diagnosis of new and old vertebral compresion fracture.Methods One hundred and sixty-seven cases with the new and old vertebral compresion fracture who have 189 vertebrae in total were examined using the MSCT scanning,their imaging information were postprocessed with 2D and 3D reconstruction at the work station.Thirty-four patients with overall 43 vertebrae were carried out by MRI scanning and their images were compared with those of MSCT.Results They had the highest proportion of vertebrae in L1 with accounting for 27.68% (31/112) and 35.06% (27/77) among the patients with new and old vertebral compresion fracture,respectively.The next was T12,L2 and T11.There were statistically significant differences between new and old cases in such appearance as fracture line clear and sharp(102 and 21),contusion and hemorrhage of spinal cord(15 and 0),parenchyma shadow beside vertebrae(103 and 11),appendant fracture(26 and 5),organ's lacerated wound around vertebral body(30 and 0),discus intervertebrales vacuum(10 and 36),derangement and hardening of vertebral bone trabecularism(29 and 51) (P＜0.01).Twenty-six vertebrae with the uneven low T1 WI signal,27 vertebrae with the T2 WI fat-suppresion irregular high signal were demonstrated in MRI scanning among 27 vertebrae of 21 cases with new vertebral compresion fracture.While 16 vertebrae with the T1WI and T2WI signals were the same as those of the normal vertebrae,16 vertebrae were the T2WI fat-suppresion low signal among 13 cases with old vertebral compresion fracture.Conclusions The MSCT plays an important role in identifying diagnosis for the most of the patients with the new and old vertebral compresion fracture, while MRI scanning may reflect the pathophysiological characteristics in diagnosis of the spinal cord and the ligament lesion.Therefore,the MSCT and MRI scanning should be integrated to be used to enhance remarkably the accurate rate of the diagnosis.