Rupp R E, Ebraheim N A, Coombs R J
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
Spine (Phila Pa 1976). 1995 Dec 1;20(23):2499-503; discussion 2504. doi: 10.1097/00007632-199512000-00007.
This study reviewed the magnetic resonance imaging characteristics of atraumatic compression fractures or vertebral lesions caused by osteoporosis of tumor.
The purpose of this study was to evaluate the magnetic resonance imaging characteristics that will allow differentiation of compression fractures or vertebral lesions due to osteoporosis or tumor.
Previous reports have identified several magnetic resonance imaging characteristics of benign and malignant compression fractures. However, diagnosis has been confirmed primarily by clinical follow-up and not pathologic biopsy specimen.
Thirty-four cases of atraumatic compression fractures or vertebral lesions that had undergone magnetic resonance imaging evaluation followed by biopsy were retrospectively reviewed. Conventional magnetic resonance imaging with T1- and T2-weighted images were obtained in all cases and gadolinium was used in 21 cases. Each case was evaluated for magnetic resonance imaging characteristics of the compression fractures or vertebral lesions that included decreased T1 and increased T2 signal, marrow preservation on the T1 image, gadolinium lesion enhancement, multiple level involvement, associated soft tissue mass, posterior vertebral expansion, and pedicle involvement.
Eighteen of the compression fractures or vertebral lesions were confirmed as tumor and 16 were confirmed as osteoporosis by biopsy. Decreased T1- weighted and increased T2-weighted signals are sensitive but not specific for tumor involvement. Normal marrow preservation of the compressed vertebral body on T1 imaging is consistent with an osteoporotic fracture or lesion. Gadolinium enhancement, multiple level involvement, and posterior vertebral expansion are not useful for differentiation of osteoporotic from tumor fractures or lesions. Pedicle involvement or an associated soft tissue mass are specific for a tumor compression fracture or vertebral lesion.
There are characteristic magnetic resonance imaging findings of compression fractures or vertebral lesions that allow sensitive and specific differentiation of osteoporosis from tumor.
本研究回顾了由骨质疏松或肿瘤导致的非创伤性压缩性骨折或椎体病变的磁共振成像特征。
本研究的目的是评估磁共振成像特征，以区分骨质疏松或肿瘤引起的压缩性骨折或椎体病变。
既往报告已确定了良性和恶性压缩性骨折的几种磁共振成像特征。然而，诊断主要通过临床随访而非病理活检标本得以证实。
回顾性分析34例接受磁共振成像评估并随后进行活检的非创伤性压缩性骨折或椎体病变病例。所有病例均获取了常规的T1加权和T2加权磁共振成像，21例使用了钆剂。对每个病例的压缩性骨折或椎体病变的磁共振成像特征进行评估，包括T1信号降低和T2信号增加、T1图像上骨髓保留、钆剂病变强化、多节段受累、相关软组织肿块、椎体后部扩展以及椎弓根受累情况。
活检证实18例压缩性骨折或椎体病变为肿瘤，16例为骨质疏松。T1加权信号降低和T2加权信号增加对肿瘤累及敏感但不具特异性。T1成像时压缩椎体的骨髓正常保留与骨质疏松性骨折或病变一致。钆剂强化、多节段受累以及椎体后部扩展对区分骨质疏松性骨折与肿瘤性骨折或病变并无帮助。椎弓根受累或相关软组织肿块对肿瘤性压缩性骨折或椎体病变具有特异性。
压缩性骨折或椎体病变存在特征性磁共振成像表现，可敏感且特异性地区分骨质疏松与肿瘤。
