Identification Of Magnetic Resonance Signature Features Of Benign And Malignant Vertebral Compression Fractures

Objective: To explore the characteristic signs of magnetic resonance imaging in differentiating benign and malignant vertebral compression fractures,and to improve the level of differential diagnosis between benign and malignant vertebral compression fractures.Methods: A total of 121 patients with compression fractures were enrolled in the outpatient and inpatient PACS systems of the Jinggangshan University Hospital from July 2017 to December 2018.According to the inclusion criteria and exclusion criteria,106 patients were enrolled,including benign lesions52 patients,54 patients with malignant lesions;all patients underwent routine T1 WI,T2WI and fat suppression sequence scans,from the number and distribution of lesions,vertebral morphology,vertebral body signals,vertebral attachment,soft tissue mass or swelling Analysis and induction of spinal cord changes.All data were statistically analyzed using SPSS 21.0 statistical software.Results:(1)There were significant differences in vertebral bulging and horny protrusion between benign and malignant fractures(P<0.05).There were more horny protrusions in benign compression fractures,and more bulging vertebral margins in malignant compression fractures.(2)The vertebral bodies of benign compression fractures are mostly partial signal abnormalities.T1 WI mostly has localized low signal,T2 WI and fat suppression sequences are mostly high signals,and the vertebral body signal morphology is the same as before;the malignant compression fractures are mostly vertebral bodies.Abnormal signal,T1 WI showed diffuse low signal,T2 WI and fat suppression sequence showed high signal,and vertebral abnormal signal pattern was mainly patchy(P<0.05).(3)There are 6 vertebral body attachments in the vertebral body of benign compression fracture,all of which are pedicle;48 vertebral body attachments are involved in the vertebral body of malignant compression fracture,including 10 pedicles,31 vertebral plates,joints 3 sudden,2 transverse processes,2spinous-processes.The incidence of vertebral attachments in benign compression fractures was significantly less than that in malignant compressionfractures(P<0.05).(4)There are 7 soft tissue shadows in the vertebral body of benign compression fractures,all of which are limited and limited to the scope of the vertebral body.There were 50 soft tissue shadows in the vertebral body of malignant compression fractures,28 of which were significantly more than the vertebral body,26 were diffuse and 24 were limited.Soft tissue shadows of benign compression fractures were significantly less than malignant compression fractures(P<0.05).(5)The spinal cord compression and T2 WI patchy high signal of benign compression fracture were significantly less than malignant compression fracture(P<0.05).(6)Posterior margin swelling,vertebral appendage involvement and soft tissue mass of vertebral body have high specificity,97.96%,93.88% and 92.86% respectively.They also have high positive predictive value,96.00%,88.89% and 87.72% respectively.The sensitivities of soft tissue mass,posterior margin swelling and accessory involvement were 65.79%,63.16% and 63.16% respectively,and the corresponding negative predictive values were 77.78%,77.42% and 76.67%,respectively.The specificity of water-like signal bands in vertebral body was 85.51%,but the sensitivity was only 2.63%.Conclusion: Magnetic resonance imaging can clearly show the imaging characteristics of vertebral compression fractures caused by benign and malignant lesions.It can be differentiated from the morphological and signal changes of vertebral body,the involvement of vertebral appendages,soft tissue mass or swelling,and the changes of spinal cord.The posterior margin of vertebral enlargement,the involvement of vertebral appendages and soft tissue mass of vertebral body have high specificity,97.96%,93.88% and 92.86% respectively,and they also have high sensitivity.Vertebral water-like signal bands have a high specificity of 85.51%,but low sensitivity.Multiple-combination of signs can significantly improve the value of MR differential diagnosis.