骨质疏松椎体骨折的MRI-STIR与CT对应及其与骨折不愈合的关系研究

发布时间：2018-04-30 18:35

本文选题：骨质疏松椎体骨折 + MRI-STIR　；参考：《广西中医药大学》2017年硕士论文

【摘要】：研究一骨质疏松椎体骨折MRI-STIR信号改变与CT骨折线类型的关系研究目的:本研究探讨骨质疏松椎体骨折的MRI-STIR信号改变与CT骨折线形态之间关系,为CT判断骨质疏松骨折椎体预后提供临床依据。方法:2014年1月1日至2014年9月30日在我院脊柱外科诊断为骨质疏松椎体骨折的病例,回顾性分析纳入标准病例138例,其中男性患者43例,女性患者95例,骨折椎体154节(腰椎98节、胸椎56节),年龄63~104岁,平均年龄为71.3岁,病程1~21天,平均病程为13.7天。入院后完善CT、MRI检查,将患椎的MRI-STIR信号改变分为黑色线信号、无同源高信号、同源高信号A、B、C三组,将CT骨折类型分为嵌插型、开裂型、微骨折型。观察骨质疏松椎体骨折MRI-STIR信号与CT骨折类型的改变。结果:MRI-STIR黑色线信号椎体有56个、无同源高信号有48个,同源及无黑线信号有50个。经统计学分析:(1)对应CT上呈现出嵌插型方面,三组间比较,χ~2=27.066,P=0.000 P0.05为差异有统计学意义;A、B两组间对比,χ~2=13.676,P=0.000 P0.016为差异有统计学意义,A、C两组间对比,χ~2=24.060,P=0.000,P0.016为差异有统计学意义;B、C两组间对比,χ~2=1.576,P=0.290 P0.016为差异无统计学意义。其中A组阳性率为69%,B组阳性率33%,C组阳性率22%。(2)对应CT上呈现出开裂型方面,三组间比较,χ~2=13.243,P=0.015 P0.05为差异有统计学意义;A、B两组间对比,χ~2=5.922,P=0.015 P0.016为差异有统计学意义;A、C两组间对比,χ~2=1.359,P=0.244 P0.016为差异无统计学意义;B、C两组间对比,χ~2=11.911,P=0.001 P0.016为差异有统计学意义。其中A组阳性率为23%,B组阳性率46%,C组阳性率14%。(3)对应CT呈现出微骨折型方面,三组间比较,χ~2=50.666,P=0.000 P0.05为差异有统计学意义;A、B两组间对比,χ~2=5.922,P=0.015 P0.016为差异有统计学意义;A、C两组间对比,χ~2=1.359,P=0.244 P0.016为差异无统计学意义;B、C两组间对比,χ~2=11.911,P=0.001 P0.016为差异有统计学意义。其中A组阳性率为5%,B组阳性率18%,C组阳性率66%。STIR黑色线信号在CT上呈现主要为嵌插型,STIR无同源高信号在CT上主要呈现为开裂型,STIR同源高信号在CT上主要呈现为微骨折型结论:骨质疏松椎体骨折的MRI-STIR信号改变与CT骨折线形态之间存在关系,STIR黑色线信号在CT上呈现主要为嵌型,STIR无同源高信号在CT上主要呈现为开裂型,STIR同源高信号在CT上主要呈现为微骨折型。研究二新鲜骨质疏松椎体骨折MRI-STIR信号改变与骨折不愈合的关系研究目的:通过研究新鲜骨质疏松椎体骨折MRI-STIR信号改变与骨折不愈合的关系,为预测骨折不愈合提供临床依据。方法:收集在我院及外院诊断为骨质疏松椎体骨折的纳入标准病例52例,其中男性患者11例,女性患者41例,骨折椎体66节(腰椎37节、胸椎29节),年龄69~83岁,平均年龄为73岁,平均病程为15天。平均终末随访时间为8个月。52个病例均采用保守治疗,将新鲜的骨质疏松椎体骨折MRI-STIR信号改变分为黑色线信号、无同源高信号、同源高信号A、B、C三组,观察三组骨折椎体愈合的情况。结果:黑色线信号椎体有24个,愈合数为3个,愈合率为12%;无同源高信号25个,愈合数为16个,愈合率为64%;同源高信号17个,愈合数为15个,愈合率为88%;经统计学分析,三组间较:χ~2=25.362,P=0.000,P0.05;A、B两组间对比,χ~2=13.680,P=0.000,P0.016为差异有统计学意义;A、C两组间对比,χ~2=23.176,P=0.000 P0.016为差异有统计学意义;B、C两组间对比,χ~2=3.075,P=0.080 P0.016为差异无统计学意义结论:新鲜骨质疏松椎体骨折MRI-STIR信号改变可预测椎体骨折预后,MRI-STIR黑色线信号代表着骨质疏松骨折椎体预后差。
[Abstract]:Study of the relationship between the MRI-STIR signal changes and the type of CT fracture line in a osteoporotic vertebral fracture. Objective: To investigate the relationship between the MRI-STIR signal changes and the shape of the CT fracture line in osteoporotic vertebral fractures, and to provide a clinical basis for judging the prognosis of osteoporotic vertebral fractures by CT. Methods: January 1, 2014 to September 30, 2014 The hospital spine surgery was diagnosed as a osteoporotic vertebral fracture in 138 cases, including 43 male patients, 95 female patients, 154 vertebrae (98 lumbar vertebrae, 56 thoracic vertebrae), age 63~104 years, the average age of 71.3 years, the course of disease 1~21 days, and the average course for 13.7 days. After admission to the hospital, the CT, MRI examination, will develop the vertebra. The MRI-STIR signal changes were divided into black line signal, no homologous high signal, homologous high signal A, B, C three groups. The type of CT fracture was divided into intercalated, cracking, and micro fracture type. The changes of MRI-STIR signal and CT fracture type of osteoporotic vertebral fracture were observed. Results: there were 56 MRI-STIR black line signal vertebrae, 48 homologous high signals, and 48 homologous and homologous There were 50 non black line signals. (1) the difference between the three groups was statistically significant. The difference between the three groups was statistically significant in the three groups, and the comparison between the three groups, the two groups of A, B two, P=0.000 P0.016 was statistically significant, and the A, C two groups were statistically significant differences. There was no statistical difference between the two groups of C, X ~2=1.576 and P=0.290 P0.016. The positive rate of A group was 69%, and the positive rate of group B was 33%. The positive rate of C group was 22%. (2) corresponding CT, and the three groups compared, Chi ~2=13.243 and P=0.015 P0.05 were statistically significant differences. The difference between A and C two groups, X ~2=1.359 and P=0.244 P0.016 was not statistically significant. B, C two groups, Chi ~2=11.911, P=0.001 P0.016 were significant differences. The positive rate of A group was 23%, the positive rate of B group was 46%, and the positive rate was 3. The three groups were compared. The difference was statistically significant for the difference between the two groups of A and B, and the difference was statistically significant between the two groups of A, C two groups, Chi ~2=1.359 and P=0.244 P0.016. B, the two groups of C two were statistically significant differences. The positive rate was 5%, the positive rate was 18%, and the positive group was positive. 66%.STIR black line signals are mainly intercalated on CT, STIR homologous high signals are mainly cracked on CT, and STIR homologous high signal is mainly shown as micro fracture type on CT: the relationship between the MRI-STIR signal change of osteoporotic vertebral fracture and the morphology of CT fracture line, and the STIR black line signal on CT. For inlay, the STIR homologous high signal is mainly cracked on CT, and the STIR homologous high signal is mainly a micro fracture type on CT. Study the relationship between the MRI-STIR signal change of two fresh osteoporotic vertebral fractures and fracture nonunion Combined relationship, to provide a clinical basis for predicting fracture nonunion. Methods: 52 cases of standard cases of osteoporotic vertebral fractures were collected in our hospital and external hospital, including 11 male patients, 41 female patients, 66 vertebrae (37 lumbar vertebrae, 29 thoracic vertebrae), 69~83 years old, the average age of 73 years, and the average end of 15 days. At the last follow-up time of 8 months,.52 cases were treated with conservative treatment. The MRI-STIR signal changes of fresh osteoporotic vertebral fractures were divided into black line signal, no homologous high signal, homologous high signal A, B, C three groups, and three groups of fracture healing were observed. Results: the black line signal vertebral body was 24, the healing rate was 3, the healing rate was 12%. The total number of high signals was 25, the healing rate was 16, the healing rate was 64%, the homologous high signal was 17, the healing rate was 15 and the healing rate was 88%. The three groups were compared with the three groups: X ~2=25.362, P=0.000, P0.05, A, B two, X ~2=13.680, P=0.000, P0.016 Study significance; B, C two groups, X ~2=3.075, P=0.080 P0.016 is the difference of no statistically significant conclusion: fresh osteoporotic vertebral fracture MRI-STIR signal changes can predict vertebral fracture prognosis, MRI-STIR black line signal represents the poor prognosis of osteoporotic fracture vertebra.

【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683

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