Study on clinical value of CT and MRI in the differential diagnosis of osteoporotic and non-osteoporotic lumbar fractures
Objective To explore the value of computed tomography(CT)and magnetic resonance imaging(MRI)in the differential diagnosis of osteoporotic and non-osteoporotic lumbar fractures.Methods The clinical data of 96 patients with lumbar fracture were retrospectively analyzed.According to the World Health Organization(WHO)gold standard for the diagnosis of osteoporosis,the patients were divided into an osteoporosis group(bone mineral density T-value≤-2.5 SD,38 cases,43 affected vertebrae)and a non-osteoporosis group(bone mineral density T-value>-2.5 SD,58 cases,67 affected vetebrae).All patients underwent lumbar MRI and lumbar CT multiplanar reconstruction scans.Both groups were compared in terms of CT features(degree of compression fracture,combined burst fracture,low density shadow in vertebra,fracture involvement of appendages,and vertebral cancellar bone CT values),MRI features(lumbar T1-weighted imaging,lumbar T2-weighted imaging,short-time reversal recovery sequence,combined spinal cord or cauda equina injury)and paravertebral muscle MRI indicators(cross-sectional area of bilateral paravertebral muscle,vertebral cross-sectional area,lumbar muscle degree,and percentage of fatty degeneration).Results In the osteoporosis group,the percentage of moderate and severe compression fracture was 86.05%(37/43),the percentage of combined burst fracture was 41.86%(18/43),the percentage of low density shadow in vertebra was 72.09%(31/43),and the percentage of fracture involvement of appendages was 41.86%(18/43),which were significantly higher than 53.73%(36/67),13.43%(9/67),10.45%(7/67),and 10.45%(7/67)in the non-osteoporosis group;the CT value of vertebral cancellous bone of(74.36±15.10)HU was significantly lower than(113.24±16.20)HU in the non-osteoporosis group;the difference was statistically significant(P<0.05).The short-time reversal recovery sequence of the osteoporosis group showed mostly high signal(74.42%)and the non-osteoporosis group showed mostly mixed signal(50.75%),and the difference between the groups was statistically significant(χ2=22.963,P<0.05).There was no statistical significance in the comparison of the scanning signals of lumbar T1-weighted imaging and lumbar T2-weighted imaging between the two groups(P>0.05).The percentage of combined spinal cord or cauda equina injury was 88.37%(38/43)in the osteoporosis group,which was significantly higher than 4.48%(3/67)in the non-osteoporosis group,and the difference was statistically significant(χ2=78.844,P<0.05).In the osteoporosis group,the cross-sectional area of bilateral paravertebral muscle was(3001.25±635.10)mm2,the lumbar muscle degree was(225.43±40.30)%,and the percentage of fatty degeneration was(10.02±1.02)%,which were significantly lower than(3378.46±608.65)mm2,(272.85±42.46)%,and(10.88±1.12)%in the non-osteoporosis group,and the difference was statistically significant(P<0.05).There was no statistical significance in the vertebral cross-sectional area between the two groups(P>0.05).Conclusion There are significant differences in CT and MRI imaging features between osteoporotic and non-osteoporotic lumbar fractures.Patients with osteoporotic lumbar fractures have a higher percentages of moderate and severe compression fractures,burst fractures,low density shadow in vertebra,fracture involvement of appendages,and high signal in short-time reversal recovery sequence.CT values of the cancelous bone of the lumbar vertebrae are significantly lower than those of patients with non-osteoporotic lumbar fractures,and lumbar paravertebral muscle degeneration is present.Therefore,osteoporotic and non-osteoporotic lumbar fractures can be distinguished by CT values.The combination of the two can further improve the diagnostic efficiency of lumbar fractures.
万方数据
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