欢迎访问《现代生物医学进展》编辑部！

目的：探讨MR弥散加权成像(DWI)鉴别诊断良恶性椎体压缩性骨折的临床价值。方法：对57 例经临床或病理证实的椎体良恶性压缩性骨折患者行矢状位T1WI、T2WI、T2WI/FS 及DWI扫描，研究其在常规序列和DWI序列上的表现，将常规MR 序列和DWI序列检出率进行比较，测量正常椎体及病变椎体的表观弥散系数(ADC)值，并进行统计学分析。结果：(1)MR 常规序列和 DWI序列(b=500s/mm2)表现：良性椎体压缩性骨折呈长T1 长或等T2 改变，T2WI/FS 呈高信号，DWI 可以呈高信号、等信号及低信号；恶性椎体压缩性骨折呈长T1 长T2 信号，大部分病灶T2WI/FS 及DWI呈高信号，少数变现为低信号；(2)MR 常规序列和 DWI 序列(b=500s/mm2)病灶检出率的比较：T1WI、T2WI/FS 及DWI序列病灶检出率均高于T2WI 序列，其间的差别有显著性意义(P<0.01)，T1WI、T2WI/FS 及DWI序列病灶检出率之间无显著性差异(P>0.01)；(3)ADC 值比较：在DWI(b=500 s/mm2)上，良性组 ADC 值为(2.03± 0.83)× 10-3mm2/s，恶性组ADC 值为(1.37 ± 0.75)× 10-3mm2/s，正常组ADC值为(0.36± 0.21)× 10-3mm2/s，成像条件相同时，良性组高于恶性组，两组间有明显的统计学意义(P<0.05)。结论：DWI可较好的反映椎体的弥散特征，ADC值作为量化指标可对良恶性椎体压缩性骨折进行可靠鉴别。

英文摘要:

Objective:To investigate the clinical value of MR diffusion weighted imaging in the differential diagnosis of benign and malignant vertebral compression fractures.Methods:57 patients with vertebral compression fractures(confirmed by clinic or pathology) were performed with sagittal T1WI, T2WI, T2WI/FS and DWI respectively. The capability to show the lesion on T1WI、T2WI、 T2WI/ FS and DWI (b=500 s/mm2)were compared. Meanwhile, on DWI(b=500 s/mm2), the ADCs of the vertebral compression fractures and normal vertebral were analyzed.Results:(1)The appearance of routine MR sequence and DWI sequence (b=500s/mm2): benign vertebral compression fractures showed long T1, long T2, T2WI/FS high signal, DWI could display high and low signal; malignant vertebral compression fractures long T1 and long T2 signal, most lesions on T2WI/FS and DWI showed high signal, few ones low signal; (2)The capability to show the lesions on DWI(b=500 s/mm2) and general MRI. The capability to show the lesions on T1WI, T2WI/FS and DWI (b=500 s/mm2) were similar(P >0.01), which were higher than that of T2WI(P <0.01). (3)The ADCs of lesions and normal vertebrae were: b=500 s/mm2，the benign group ADC value(2.03 ± 0.83)× 10-3 mm2/s, the malignant group (1.37 ± 0.75)× 10-3 mm2/s, the normal group (0.36 ± 0.21)× 10-3 mm2/s. The ADCs of benign group were higher than that of malignant group(P<0.01).Conclusion:DWI could efficiently reflect the diffusion characterizations. The benign and malignant vertebral compression fractures could be reliably distinguished by comparing the ADC.

View Full Text View/Add Comment Download reader