文明昆 周燚 陶一帆

【摘 要】目的：分析磁共振成像（MRI）非对称回波三点法水脂分离技术诊断脊柱压缩性骨折的价值。方法：回顾性分析我院2018年6月-2019年6月期间收治的脊柱压缩性骨折患者60例临床资料，将病理诊断结果为良性的30例患者的临床资料归为良性组，将病理诊断结果为恶性的30例患者的临床资料归为恶性组。两组均行MRI非对称回波三点法水脂分离技术诊断，比较两组MRI的影像特征及相对信号值。结果：恶性组倒楔形的椎体形态、椎体后缘膨隆、环形增后及结节肿块占比均高于良性组，椎体形态呈楔形、椎体后缘成角占比低于良性组，差异有统计学意义（P<0.05）;恶性组水脂像比值低于良性组，同反相位比值高于良性组，差异有统计学意义（P<0.05）。结论：应用MRI非对称回波三点法水脂分离技术的诊断效果较好，可有效鉴别良恶性脊柱压缩性骨折，可为临床治疗方案的制定提供客观参考。

【关键词】脊柱压缩性骨折;磁共振成像非对称回波三点法水脂分离技术;诊断价值

Abstract： objective： To analyze the value of magnetic resonance imaging （MRI） asymmetric echo three-point water-fat separation technique in the diagnosis of spinal compression fractures. Methods The clinical data of 60 patients with spinal compression fractures treated in our hospital from June 2018 to June 2019 were retrospectively analyzed. The clinical data of 30 patients whose pathological diagnosis was benign were classified as benign groups， and the pathological diagnosis results were included. The clinical data of 30 patients who were malignant were classified as malignant group. Both groups were diagnosed by MRI asymmetric echo three-point water-fat separation technique， and the MRI image characteristics and relative signal values were compared between the two groups. Results In the malignant group， the inverted vertebral morphology， vertebral posterior margin bulging， ring enlargement， and nodular mass were higher than those in the benign group. The vertebral morphology was wedge-shaped， and the vertebral posterior margin angled ratio was lower than in the benign group. The difference was statistically significant （P <0.05）; the water-lipid ratio in the malignant group was lower than that in the benign group， and the inverse phase ratio was higher than that in the benign group， and the difference was statistically significant （P <0.05）. Conclusion The MRI asymmetric echo three-point water-fat separation technique has a good diagnosis effect， can effectively distinguish benign and malignant spinal compression fractures， and can provide an objective reference for the formulation of clinical treatment plans.

Keywords： Spinal compression fracture; Magnetic resonance imaging asymmetric echo three-point water-fat separation technique; Diagnostic value

【中圖分类号】R43【文献标识码】A【文章编号】1672-3783（2020）04-12-013-01

临床上根据脊柱压缩性骨折的诱发因素，可将其分为良性、恶性骨折两种，其中良性骨折多由骨质疏松、脊柱结核、外伤等因素所致，而恶性骨折多由骨肿瘤侵犯椎骨所致[1]。不同性质的骨折其临床治疗方式也存在较大差异，故如何准确的对脊柱压缩性骨折进行准确诊断，对治疗方案的制定与实施及患者病情恢复均有重要意义。磁共振成像（MRI）非对称回波三点法水脂分离技术诊断对脂肪抑制效果具有很好的改善作用，可以克服磁场不均匀性，提高影像质量，因此逐渐应用至脊柱压缩性骨折的疾病诊断中，然而临床上关于其对脊柱压缩性骨折的诊断价值尚有争议[2]。……