[1]程克斌,王晨,蒋雯,等.急性或亚急性骨质疏松性椎体骨折椎体内真空裂隙 的MRI表现[J].中医正骨,2013,25(12):45-48.
点击复制

急性或亚急性骨质疏松性椎体骨折椎体内真空裂隙 的MRI表现()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年12期
页码:
45-48
栏目:
骨质疏松症
出版日期:
2013-12-30

文章信息/Info

作者:
程克斌王晨蒋雯张晶于爱红梁伟顾翔程晓光
北京积水潭医院,北京 100035
关键词:
脊柱骨折 骨质疏松性骨折 椎体内真空裂隙 体层摄影术螺旋计算机 磁共振成像 椎体成形术
摘要:
目的:探讨急性或亚急性骨质疏松性椎体骨折中椎体内真空裂隙的MRI表现。方法:回顾性分析44例确诊的急性或亚急性骨 质疏松性椎体骨折且存在椎体内真空裂隙患者的多层螺旋CT和MRI资料。男16例,女28例。年龄54~90岁,中位数72.5岁。多层螺 旋CT与MRI检查的时间间隔0~14 d,中位数4.5 d。骨折椎体按照压缩程度分为轻度压缩、中度压缩和重度压缩; 在多层螺旋CT 上,根据气体的形态和大小将椎体内真空裂隙分为线性、局限性和弥漫性; 在MRI上,椎体内真空裂隙分为未见气体和液体性、气 体性、液体性、气体液体混合性。分析多层螺旋CT表现与MRI表现的关联性,以及多层螺旋CT表现与椎体塌陷程度的关联性。结 果:①影像学检查结果。本组44例急性或亚急性椎体骨折共涉及57椎,35例为单发,9例为多发。44椎内可见真空裂隙,其中 T11椎体3椎、T12椎体18椎、L1椎体18椎、L2椎体3椎、L3椎体1 椎、L4椎体1椎。②影像学分型结果。按照椎体压缩程度,可见椎体内真空裂隙的椎体轻度压缩10椎、中度压缩13椎 、重度压缩21椎; 按照多层螺旋CT表现分型,线性17椎、局限性17椎、弥漫性10椎; 按照MRI表现分型,未见气体和液体性5椎、 气体性23椎、液体性11椎、气体液体混合性5椎。急性或亚急性椎体骨折的压缩程度与椎体内真空裂隙的多层螺旋CT表现无关联 (P=0.661); 椎体内真空裂隙的多层螺旋CT表现和MRI表现有关联(P=0.000),椎体内真空裂隙在MRI上主要表现为气体和(或)液体 积聚。结论:在急性或亚急性骨质疏松性椎体骨折中,椎体内真空裂隙在MRI上主要表现为气体和(或)液体积聚。

参考文献/References:

[1] Theodorou DJ.The intravertebral vacuum cleft sign[J].Radiology,2001,221(3):787-788.
[2] Maldague BE,Noel HM,Malghem JJ.The intravertebral vacuum cleft:a sign of ischemic vertebral collapse [J].Radiology,1978,129(1):23-29.
[3] Libicher M,Appelt A,Berger I,et al.The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures:results from a radiological and histological study[J].Eur Radiol,2007,17 (9):2248-2252.
[4] Lane JI,Maus TP,Wald JT,et al.Intravertebral clefts opacified during vertebroplasty:pathogenesis,technical implications,and prognostic significance[J].AJNR Am J Neuroradiol,2002,23(10):1642-1646.
[5] Peh WC,Gelbart MS,Gilula LA,et al.Percutaneous vertebroplasty:treatment of painful vertebral compression fractures with intraosseous vacuum phenomena[J].AJR Am J Roentgenol,2003,180(5):1411-1417.
[6] McKiernan F,Faciszewski T.Intravertebral clefts in osteoporotic vertebral compression fractures [J].Arthritis Rheum,2003,48(5):1414-1419.
[7] Linn J,Birkenmaier C,Hoffmann RT,et al.The intravertebral cleft in acute osteoporotic fractures:fluid in magnetic resonance imaging-vacuum in computed tomography?[J].Spine(Phila Pa 1976),2009,34(2):E88-E93.
[8] Mathis JM.Percutaneous vertebroplasty:complication avoidance and technique optimization[J].AJNR Am J Neuroradiol,2003,24(8):1697-1706.
[9] Carlier RY,Gordji H,Mompoint DM,et al.Osteoporotic vertebral collapse:percutaneous vertebroplasty and local kyphosis correction[J].Radiology,2004,233(3):891-898.
[10] Wiggins MC,Sehizadeh M,Pilgram TK,et al.Importance of intravertebral fracture clefts in vertebroplasty outcome[J].AJR Am J Roentgenol,2007,188(3):634-640.
[11] Mirovsky Y,Anekstein Y,Shalmon E,et al.Intradiscal cement leak following percutaneous vertebroplasty [J].Spine(Phila Pa 1976),2006,31(10):1120-1124.
[12] Stäbler A,Schneider P,Link TM,et al.Intravertebral vacuum phenomenon following fractures:CT study on frequency and etiology[J].J Comput Assist Tomogr,1999,23(6):976-980.
[13] Genant HK,Wu CY,van Kuijk C,et al.Vertebral fracture assessment using a semiquantitative technique[J].J Bone Miner Res,1993,8(9):1137-1148.
[14] Sarli M,Pérez Manghi FC,Gallo R,et al.The vacuum cleft sign:an uncommon radiological sign [J].Osteoporos Int,2005,16(10):1210-1214.
[15] Malghem J,Maldague B,Labaisse MA,et al.Intravertebral vacuum cleft:changes in content after supine positioning[J].Radiology,1993,187(2):483-487.
[16] Yu CW,Hsu CY,Shih TT,et al.Vertebral osteonecrosis:Mr imaging findings and related changes on adjacent levels[J].AJNR Am J Neuroradiol,2007,28(1):42-47.
[17] Kim HS,Kim SH,Ju CI,et al.The role of bone cement augmentation in the treatment of chronic symptomatic osteoporotic compression fracture[J].J Korean Neurosurg Soc,2010,48(6):490-495.

备注/Memo

备注/Memo:
2013-04-26收稿 2013-05-24修回
基金项目:北京市卫生系统高层次卫生技术人才培养项目(2009-2-03)
通讯作者:张晶 E-mail:zhangjing7007@sohu.com
更新日期/Last Update: 2013-12-30