The Clinical Application Study Of Discriminating Benign From Malignant Vertebral Compression Fracture With MRI Chemical Shift In Phase And Out Of Phase Of Imaging

BackgroundThe spine is metastatic sigmoidal. Sometimes primary tumors can be difficult to find sometimes. Spinal transfer may be the first-rank symptoms, and then common in thoracic and lumbar spinal. The diagnosis of benign and malignant vertebral fractures is difficult. The early detection of vertebral benign and malignant fracture is not only helpful to find out the right TNM staging of primary tumors and primary nidus, but is significant for therapeutic schedules. There is shortage of characteristics of vertebral benign and malignant fracture in these regular MRI, CT, X-ray. MR chemical shift can display horizontally organization or lesions containing fats and water composition in cells, and especially it can be quite sensitive to fat signals. The estimating value of MRI chemical shift is affirmed on the diagnosis of liver and adrenal nidus, but the vertebral research is at the beginning stage.ObjectivesThe aim of the thesis is to evaluate the application value of MR chemical shift in phase and out of phase of imaging in diagnosis and identification of benign and malignant vertebral fractur。Materials and MethodsImaging sequences T1-weighted spin echo fat saturation and short inversion recovery sequences, T2-weighted spin echo, Gradient recalled echo and in phase and out of phase imaging (chemical shift imaging), contrast-T1-weighted spin echo.50 vertebral fracture (126 vertebra) patient, including 17 pathologic compression fracturs (47 vertebra including 47 metastasis) and 33 benign fracture (44 vertebra including 15 traumatic and 36 osteoporotic fractures, 1 hemangioma,2 tuberculosis). According to the results of physical examinations,the findings of X radiology,CT,ECT,PET-CT and the findings of radiology and pathology,126 vertebra were divided into the normal vertebral group (35 cases). The benign vertebral group (44cases, which include 20 thoracic vertebra,24 lumbar). The malignant vertebral group (47cases, which include 2 cervical,21 thoracic,24 lumbar vertebra). The signal intensity ratios on in phase and out of phase of the vertebral lesions as well as signal intensity ratios (SIR= The signal intensity ratios on in phase of the vertebral/The signal intensity ratios out of phase of the vertebral) were compared and analyzed between the three groups.ResultsThe mean of the normal vertebral group's relative intensity (0.36±0.11); the mean of benign vertebral group's relative intensity (0.65±0.17); the mean of the malignant vertebral group's relative intensity (0.82±0.14). There was a significant difference in SIR between vertebral malignancy and benign vertebral group except infections (P<0.05), between the normal and benign vertebral group except infections (P<0.05), and between the normal and malignant vertebral group except infections (P<0.05).Conclusions(1) The relative signal strength of the normal vertebral group is minimal, the one of the benign compression fracture group medium, and the one of malignant compression fracture group maximum.(2) There are intersections between the normal group and the benign group and between the benign group and the malignant group.(3) It is of significance that MR chemical in phased and out of phased shift technique can be applied to identify the benign and malignan vertebral compression fractur...