Kanchiku Tsukasa, Taguchi Toshihiko, Toyoda Koichiro, Fujii Kenzo, Kawai Shinya
Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Spine (Phila Pa 1976). 2003 Nov 15;28(22):2522-6; discussion 2. doi: 10.1097/01.BRS.0000092384.29767.85.
This was a retrospective study of the relation between the blood perfusion of bone marrow in injured vertebrae and the degree of subsequent vertebral collapse in patients with osteoporotic vertebral fractures.
The objective was to evaluate blood perfusion of bone marrow in injured vertebrae using dynamic magnetic resonance imaging and study the possibility of predicting the progression of vertebral collapse.
Avascular necrosis of the vertebra is considered to be a cause of delayed vertebral collapse following osteoporotic vertebral fractures, but studies on the relation with the degree of progression of vertebral collapse by evaluation of vertebral blood perfusion have not been reported.
The subjects were 15 vertebrae in 14 patients with osteoporotic vertebral fractures, including 11 women and three men with a median age of 79 years. All patients underwent dynamic magnetic resonance imaging soon after the fracture and the area rate of the noncontrast region of the injured vertebrae in dynamic magnetic resonance imaging was measured. The correlation with the degree of progression of vertebral collapse obtained from plain radiograph imaging was studied.
The vertebral collapse rate (percentage loss in vertebral body height) on initial examination was 17 +/- 10% (mean +/- SD) and that at the final examination was 33 +/- 19%, showing a progression of 16 +/- 11%. The noncontrast area rate in dynamic magnetic resonance imaging was 18 +/- 12%. A significant correlation was found between the degree of progression of vertebral collapse and the noncontrast area rate (Spearman r = 0.97, P < 0.001).
The subsequent progression of vertebral collapse tended to increase the greater the noncontrast area in the injured vertebrae in dynamic magnetic resonance imaging. Dynamic magnetic resonance imaging appears to be useful in predicting the progression of collapse of fractured vertebrae.
这是一项关于骨质疏松性椎体骨折患者受伤椎体骨髓血灌注与随后椎体塌陷程度之间关系的回顾性研究。
目的是使用动态磁共振成像评估受伤椎体的骨髓血灌注，并研究预测椎体塌陷进展的可能性。
椎体缺血性坏死被认为是骨质疏松性椎体骨折后椎体延迟塌陷的一个原因，但通过评估椎体血灌注来研究其与椎体塌陷进展程度关系的研究尚未见报道。
研究对象为14例骨质疏松性椎体骨折患者的15个椎体，其中包括11名女性和3名男性，中位年龄79岁。所有患者在骨折后不久均接受了动态磁共振成像检查，并测量了动态磁共振成像中受伤椎体非强化区域的面积率。研究其与X线平片成像所得椎体塌陷进展程度的相关性。
初次检查时椎体塌陷率（椎体高度丢失百分比）为17±10%（均值±标准差），末次检查时为33±19%，进展了16±11%。动态磁共振成像中的非强化面积率为18±12%。发现椎体塌陷进展程度与非强化面积率之间存在显著相关性（Spearman秩相关系数r = 0.97，P < 0.001）。
动态磁共振成像中受伤椎体的非强化面积越大，随后椎体塌陷的进展往往越明显。动态磁共振成像似乎有助于预测骨折椎体的塌陷进展。
