T2加权预饱和脂肪抑制在椎体隐性骨折中的诊断价值

摘要

目的:探讨T2加权预饱和脂肪抑制(T2WI-FS)在椎体隐性骨折中的诊断价值.方法:106例脊柱外伤患者在伤后60天内均行X线平片及多序列高场强(1.5T)MR检查,检查序列包括SE T1WI、快速SE T2WI,T2 WI-FS等.受伤部位为颈椎6例,胸椎37例,腰椎63例.结果:106例X线平片均未见明显骨折征象.MR检查发现:6例颈椎受伤病例中隐性骨折7个椎体,37例胸椎受伤病例中隐性骨折51个椎体.63例腰椎受伤病例中隐性骨折69个椎体;MR信号主要表现为T1WI呈水平方向椎体中央条带状低信号影;T2WI呈条带状稍低信号影或等信号影;T2WI-FS呈清晰的更大范围的条带状高信号影.T2WI-FS序列醒目易认识辨别.结论:MRI能发现脊柱椎体早期至慢性期隐性骨折的存在,如临床强烈提示骨折可能而X线检查阴性者,MR检查的T2WI-FS序列是明确诊断的最佳序列.应作为脊柱创伤MR检查的常规序列.%Objective: To investigate the value of MR imaging of T2 WI fat suppressed (T2 WI-FS) sequence in detecting vertebral body occult fractures. Methods:106 patients with spinal trauma were studied using radiography and MR imaging within 60 days. MR sequences includcd SE T1 WI, FSE T2 WI and T2 WI-FS, 6 occult fractures occurred in the cervical vertebral. 37 in the thoracic vertebral and 63 in the lumbar vertebral. Results: All 106 cases had normal radiographic results. There were 7 cervical vertebral occult fracrures in 6 cases ; There were 51 thoracic vertebral occult fractures in 37 cascs; There were 69 lumbar vertebral occuit fractures in 63 cases. MR imaging demonstrated horizontal lincar low signal in the center of vertebral on T1 WI. low or equal signal on T2 WI. and high signal changes on T2 Wl-FS. The high signal on T2 WI-FS sequence was more remarkable and wider than thar on both T1 WI and T2 Wl. Conclusion: MR imaging could determine the diagnosis of acute and chronic spinal occult fractures. MRI should be The next choice when plain films fail to reveal suspected fractures in the setting of suggestive symptoms and positive physical examination, the T2 WI-FS sequence would be the best effective among the T1 WI. T2 WI and T2 WI-FS.the T2 WI-FS should be used as a routine sequence for spinal trauma.