Imaging findings and diagnostic value of MRI on thoracolumbar burst fractures accompanied with Kummell's disease
10.3969/j.issn.1005-202X.2024.09.010
- VernacularTitle:胸腰段爆裂骨折合并Kummell病的MRI表现及其诊断价值
- Author:
Yuqin LIU
1
;
Xuxue LI
;
Xiaoling LUO
Author Information
1. 四川省骨科医院医学影像科,四川成都 610000
- Keywords:
thoracolumbar burst fracture;
Kummell's disease;
magnetic resonance imaging;
ligament injury
- From:
Chinese Journal of Medical Physics
2024;41(9):1129-1132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the imaging findings and diagnostic value of magnetic resonance imaging(MRI)on thoracolumbar burst fractures accompanied with Kummell's disease.Methods A retrospective analysis was conducted on 102 patients with suspected thoracolumbar burst fractures accompanied with Kummell's disease in Sichuan Province Orthopedic Hospital.All patients underwent MRI examination.The clinical surgical diagnosis was taken as the gold standard to study the diagnostic value of MRI on thoracolumbar burst fractures accompanied with Kummell's disease and the detection of ligament injuries at thoracolumbar fracture site,and the MRI findings of thoracolumbar burst fractures accompanied with Kummell's disease were analyzed.Results The surgical results reported that out of 102 cases,58 cases were positive for thoracolumbar burst fractures accompanied with Kummell's disease and 44 cases were negative,while MRI diagnosis revealed that there were 60 positive cases and 42 negative cases,including 5 cases of missed diagnoses and 7 cases of misdiagnoses.MRI had a diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value of 91.37%,84.09%,88.23%,88.33%,88.09%and 0.758,respectively,indicating a high consistency with surgical results.The detection rates of anterior longitudinal ligament,posterior longitudinal ligament,supraspinous ligament and interspinous ligament injuries through MRI were close to surgical results(P>0.05).MRI examination showed various degrees of vertebral compression and flattening in 30 cases out of 58 cases of thoracolumbar burst fractures accompanied with Kummell's disease,and wedge-shaped changes in 25 cases.On MRI plain scan,normal bone marrow signals were still found in vertebral body in 28 cases.There were 54 cases with patchy T2WI hypointensity and lipid-suppression hypointensity in vertebral body,4 cases with thin epidural hematoma at corresponding level of vertebral body,33 cases with hypointensity on T2WI of the injured vertebral body,and 17 cases with hyperintensity on T2WI of the injured vertebral body,with the damaged ligament area being black banded structure fracture and hyperintensity on T2WI.Conclusion MRI has high diagnostic value on thoracolumbar burst fractures accompanied with Kummell's disease,and it can clearly display the signal characteristics of the diseased vertebra.
