目的: 探讨计算机断层扫描(CT)与磁共振成像(MRI)在椎体压缩骨折良恶性判断中的价值,分析其影像学特征,旨在为临床选择合理的影像学诊断方法提供数据支持。方法: 选取2022年10月至2024年10月中国人民解放军联勤保障部队990医院收治的椎体压缩骨折患者75例作为研究对象,所有患者均接受了CT与MRI检查,并经临床病理检查确诊。以病理检查结果为金标准,统计CT与MRI对椎体压缩骨折良恶性的诊断价值,分析椎体压缩骨折的CT和MRI影像学特征。结果: 病理检查结果显示,良、恶性椎体压缩骨折的例数分别为25例、50例。CT、MRI对良性椎体压缩骨折的检出例数分别为18例、23例,对恶性椎体压缩骨折的检出例数分别为40例、48例,良性检出率分别为72.00%、92.00%,恶性检出率分别为80.00%、96.00%。MRI 的良性检出率与CT相比差异无统计学意义(χ²=3.388,P＞0.05),而MRI的恶性检出率高于CT(χ²=6.061,P＜0.05),且MRI检查的灵敏度、阴性预测值、准确度均高于CT检查(P＜0.05)。良性椎体压缩骨折患者椎间盘正常的出现率(12.00%)低于恶性椎体压缩骨折患者(76.00%),椎间盘压缩的出现率(80.00%)高于恶性椎体压缩骨折患者(14.00%)(P＜0.05)。ROC曲线分析结果显示,CT和MRI鉴别良恶性椎体压缩骨折的曲线下面积(AUC)分别为0.760和0.940,MRI的诊断价值更高,其灵敏度和特异度分别为96.00%和92.00%。结论: 相较于CT,MRI可有效提高椎体压缩骨折的良、恶性检出率,灵敏度、阴性预测值和准确度均高于CT。椎间盘间隙变化可作为良恶性椎体骨折的主要鉴别影像学特征。

Objective: To explore the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of benign and malignant vertebral compression fractures, and to analyze their imaging features, so as to provide data support for clinical selection of reasonable imaging diagnosis methods. Methods: From October 2022 to October 2024, 75 patients with vertebral compression fractures admitted to the 990th Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army were selected as the research objects. All patients underwent CT and MRI examinations and were diagnosed by clinical pathological examination. Taking the pathological examination results as the gold standard, the diagnostic value of CT and MRI for benign and malignant vertebral compression fractures was statistically analyzed, and the CT and MRI imaging features of vertebral compression fractures were analyzed. Results: The results of pathological examination showed that the number of benign and malignant vertebral compression fractures was 25 cases and 50 cases, respectively. The detection cases of benign vertebral compression fractures by CT and MRI were 18 cases and 23 cases, respectively. The detection cases of malignant vertebral compression fractures were 40 cases and 48 cases, respectively. The benign detection rates were 72.00% and 92.00%, and the malignant detection rates were 80.00% and 96.00%, respectively. There was no significant difference in the benign detection rate between MRI and CT (χ²=3.388, P＞0.05), while the malignant detection rate of MRI was higher than that of CT (χ²=6.061, P＜0.05), and the sensitivity, negative predictive value and accuracy of MRI were higher than those of CT (P＜0.05). The occurrence rate of normal intervertebral disc in patients with benign vertebral compression fracture (12.00%) was lower than that in patients with malignant vertebral compression fracture (80.00%), and the occurrence rate of intervertebral disc compression (64.00%) was higher than that in patients with malignant vertebral compression fracture (14.00%) (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of CT and MRI for distinguishing benign from malignant vertebral compression fractures were 0.760 and 0.940, respectively; the diagnostic value of MRI was higher, and its sensitivity and specificity were 96.00% and 92.00%, respectively. Conclusion: Compared with CT examination, MRI examination can effectively improve the detection rate of malignant vertebral compression fractures, and improve the sensitivity, negative predictive value and accuracy. Intervertebral disc space changes can be used as the main imaging features for differential diagnosis of benign and malignant vertebral fractures.