대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제78권2호
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  • Pages.107-114
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  • 2018
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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요추 횡돌기 골절과 천추 골절의 자기공명영상 진단에서 골수 부종과 연부조직 부종의 중요성

Importance of Bone Marrow and Soft Tissue Edema to Improve the Diagnostic Accuracy of Lumbosacral MRI for Transverse Process Fractures and Sacral Fractures

  • 권지아 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 황지영 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 김민정 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 권혜영 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 김다훈 (이화여자대학교 의과대학 목동병원 영상의학과)
  • Kwon, Ji Ah (Department of Radiology, Mokdong Hospital, College of Medicine, Ewha Womans University) ;
  • Hwang, Ji Young (Department of Radiology, Mokdong Hospital, College of Medicine, Ewha Womans University) ;
  • Kim, Min Jeong (Department of Radiology, Mokdong Hospital, College of Medicine, Ewha Womans University) ;
  • Kwon, Hye Young (Department of Radiology, Mokdong Hospital, College of Medicine, Ewha Womans University) ;
  • Kim, Da Hoon (Department of Radiology, Mokdong Hospital, College of Medicine, Ewha Womans University)
  • 투고 : 2017.07.24
  • 심사 : 2017.10.11
  • 발행 : 2018.02.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 요추 횡돌기 골절과 천추 골절 환자에서 자기공명영상 소견과 진단적 정확성을 평가하고자 하였다. 대상과 방법: 척추외상으로 요천추 자기공명영상을 촬영한 214명의 환자(평균연령 60세, 남자:여자=85:129)를 대상으로 하였다. 2명의 영상의학과 의사가 골절의 유무, 개수, 척추 준위, 해부학적 위치를 평가하였고, 골절의 최종진단은 컴퓨터단층촬영 진단을 기준으로 하였다. 자기공명영상 소견은 피질골 단절, 골수 부종, 연부조직 부종으로 나누어 T1 강조영상, T2 강조영상, 지방억제 T2 강조영상에서 기술하였다. 횡돌기 및 천추 골절의 MRI 진단적 정확도를 펄스대열별로 비교하기 위해 통계학적 분석을 시행하였다. 결과: 168예의 골절 중 횡돌기 골절은 26예(15.5%), 천추 13예(4.9%)가 진단되었다. 흔한 영상소견은 횡돌기 골절 환자에서 척추 주변 연부조직 부종(80.8%), 천추 골절 환자에서 골수부종과 천추 앞 연부조직 부종(46.1%)이었다. 횡돌기 골절 진단의 민감도는 T2 강조영상에서 88%였고, 천추 골절 진단의 민감도는 T1 및 지방 억제 T2 강조영상에서 92%였다. 결론: 자기공명영상에서 골수 부종과 연부조직 부종 소견은 요추의 횡돌기 골절과 천추 골절의 진단적 정확성을 높이는데 도움이 될 것이다.

Purpose: To evaluate the magnetic resonance imaging (MRI) findings to improve the diagnostic accuracy for transverse process fractures and sacral fractures. Materials and Methods: The lumbosacral MRI scans of 214 patients (mean age, 60 years; male-to-female ratio, 85:129), who had spine trauma between January and November 2015 were included. Two radiologists evaluated the presence, number, level, and anatomic site of the fractures on MRI with computed tomography as reference standard. Imaging findings were described as cortical disruption, marrow edema, or soft tissue edema on T1-, T2-, and fat-suppressed T2-weighted images. A statistical analysis was performed to compare the diagnostic accuracy of the MRI pulse sequences for the transverse process and sacral fractures. Results: Of 168 fractures, 26 (15.5%) and 13 (4.9%) were in the transverse processes and sacra, respectively. A paravertebral soft tissue edema occurred in the transverse process fractures (80.8%) and presacral soft tissue and marrow edemas occurred in the sacral fractures (46.1%). The sensitivity for the transverse process fractures was 88% on the T2-weighted image. It was 92% on fat- suppressed T2- and T1-weighted images for sacral fractures. Conclusion: Bone marrow and soft tissue edemas on the MRI could potentially improve the diagnostic accuracy of an MRI for fractures in the transverse process and sacrum.

키워드

참고문헌

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피인용 문헌

  1. Magnetic Resonance-Based Grading of Psoas and Paraspinal Muscle Edema: Is It Helpful in Diagnosing Lumbar Transverse Process Fractures? vol.79, pp.4, 2018, https://doi.org/10.3348/jksr.2018.79.4.208