本文選題：骨質(zhì)疏松椎體骨折 + MRI-STIR��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究一骨質(zhì)疏松椎體骨折MRI-STIR信號改變與CT骨折線類型的關(guān)系研究目的:本研究探討骨質(zhì)疏松椎體骨折的MRI-STIR信號改變與CT骨折線形態(tài)之間關(guān)系,為CT判斷骨質(zhì)疏松骨折椎體預(yù)后提供臨床依據(jù)。方法:2014年1月1日至2014年9月30日在我院脊柱外科診斷為骨質(zhì)疏松椎體骨折的病例,回顧性分析納入標(biāo)準(zhǔn)病例138例,其中男性患者43例,女性患者95例,骨折椎體154節(jié)(腰椎98節(jié)、胸椎56節(jié)),年齡63~104歲,平均年齡為71.3歲,病程1~21天,平均病程為13.7天。入院后完善CT、MRI檢查,將患椎的MRI-STIR信號改變分為黑色線信號、無同源高信號、同源高信號A、B、C三組,將CT骨折類型分為嵌插型、開裂型、微骨折型。觀察骨質(zhì)疏松椎體骨折MRI-STIR信號與CT骨折類型的改變。結(jié)果:MRI-STIR黑色線信號椎體有56個、無同源高信號有48個,同源及無黑線信號有50個。經(jīng)統(tǒng)計學(xué)分析:(1)對應(yīng)CT上呈現(xiàn)出嵌插型方面,三組間比較,χ~2=27.066,P=0.000 P0.05為差異有統(tǒng)計學(xué)意義;A、B兩組間對比,χ~2=13.676,P=0.000 P0.016為差異有統(tǒng)計學(xué)意義,A、C兩組間對比,χ~2=24.060,P=0.000,P0.016為差異有統(tǒng)計學(xué)意義;B、C兩組間對比,χ~2=1.576,P=0.290 P0.016為差異無統(tǒng)計學(xué)意義。其中A組陽性率為69%,B組陽性率33%,C組陽性率22%。(2)對應(yīng)CT上呈現(xiàn)出開裂型方面,三組間比較,χ~2=13.243,P=0.015 P0.05為差異有統(tǒng)計學(xué)意義;A、B兩組間對比,χ~2=5.922,P=0.015 P0.016為差異有統(tǒng)計學(xué)意義;A、C兩組間對比,χ~2=1.359,P=0.244 P0.016為差異無統(tǒng)計學(xué)意義;B、C兩組間對比,χ~2=11.911,P=0.001 P0.016為差異有統(tǒng)計學(xué)意義。其中A組陽性率為23%,B組陽性率46%,C組陽性率14%。(3)對應(yīng)CT呈現(xiàn)出微骨折型方面,三組間比較,χ~2=50.666,P=0.000 P0.05為差異有統(tǒng)計學(xué)意義;A、B兩組間對比,χ~2=5.922,P=0.015 P0.016為差異有統(tǒng)計學(xué)意義;A、C兩組間對比,χ~2=1.359,P=0.244 P0.016為差異無統(tǒng)計學(xué)意義;B、C兩組間對比,χ~2=11.911,P=0.001 P0.016為差異有統(tǒng)計學(xué)意義。其中A組陽性率為5%,B組陽性率18%,C組陽性率66%。STIR黑色線信號在CT上呈現(xiàn)主要為嵌插型,STIR無同源高信號在CT上主要呈現(xiàn)為開裂型,STIR同源高信號在CT上主要呈現(xiàn)為微骨折型結(jié)論:骨質(zhì)疏松椎體骨折的MRI-STIR信號改變與CT骨折線形態(tài)之間存在關(guān)系,STIR黑色線信號在CT上呈現(xiàn)主要為嵌型,STIR無同源高信號在CT上主要呈現(xiàn)為開裂型,STIR同源高信號在CT上主要呈現(xiàn)為微骨折型。研究二新鮮骨質(zhì)疏松椎體骨折MRI-STIR信號改變與骨折不愈合的關(guān)系研究目的:通過研究新鮮骨質(zhì)疏松椎體骨折MRI-STIR信號改變與骨折不愈合的關(guān)系,為預(yù)測骨折不愈合提供臨床依據(jù)。方法:收集在我院及外院診斷為骨質(zhì)疏松椎體骨折的納入標(biāo)準(zhǔn)病例52例,其中男性患者11例,女性患者41例,骨折椎體66節(jié)(腰椎37節(jié)、胸椎29節(jié)),年齡69~83歲,平均年齡為73歲,平均病程為15天。平均終末隨訪時間為8個月。52個病例均采用保守治療,將新鮮的骨質(zhì)疏松椎體骨折MRI-STIR信號改變分為黑色線信號、無同源高信號、同源高信號A、B、C三組,觀察三組骨折椎體愈合的情況。結(jié)果:黑色線信號椎體有24個,愈合數(shù)為3個,愈合率為12%;無同源高信號25個,愈合數(shù)為16個,愈合率為64%;同源高信號17個,愈合數(shù)為15個,愈合率為88%;經(jīng)統(tǒng)計學(xué)分析,三組間較:χ~2=25.362,P=0.000,P0.05;A、B兩組間對比,χ~2=13.680,P=0.000,P0.016為差異有統(tǒng)計學(xué)意義;A、C兩組間對比,χ~2=23.176,P=0.000 P0.016為差異有統(tǒng)計學(xué)意義;B、C兩組間對比,χ~2=3.075,P=0.080 P0.016為差異無統(tǒng)計學(xué)意義結(jié)論:新鮮骨質(zhì)疏松椎體骨折MRI-STIR信號改變可預(yù)測椎體骨折預(yù)后,MRI-STIR黑色線信號代表著骨質(zhì)疏松骨折椎體預(yù)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.

【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R683

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