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目的:探讨MRI对脊柱结核的诊断价值。方法:回顾分析98例经手术病理证实的脊柱结核患者的脊柱MRI征象,观察椎体、终板、椎间盘及椎管等变化,并与X线平片及CT片进行比较。结果:椎体结核早期,MRI上可见椎体形态正常,椎体前中部骨质破坏,呈片状长T1、长T2信号影,边界不清;椎体终板局限性破坏,椎间盘信号不均匀,可见囊状小脓肿形成;椎旁软组织肿胀或少量脓肿形成。MRI对椎体破坏、椎间盘受累、椎旁脓肿及椎管受累的诊断优于X线平片及CT(P<0.05)。结论:MRI对病变椎体病理改变具有高敏感性,使脊柱结核的早期诊断成为可能。MRI可清晰显示脊柱结核的椎体骨炎、椎旁脓肿、终板破坏及受累椎管狭窄程度,并有助于与椎体肿瘤的鉴别。
Objective: To investigate the diagnostic value of MRI for spinal tuberculosis. Methods: The spinal MRI findings of 98 patients with spinal tuberculosis confirmed by surgery and pathology were retrospectively analyzed. The changes of vertebral body, endplate, intervertebral disc and spinal canal were observed and compared with X-ray plain film and CT film. Results: In the early stage of vertebral tuberculosis, the shape of vertebral body was normal on MRI, the bone in the anterior vertebral body was destroyed, and the long T1 and long T2 signals were patchy, the boundary was unclear. The vertebral endplate was damaged in a limited way and the disc signal was not uniform , Visible cystic small abscess formation; paravertebral soft tissue swelling or a small amount of abscess formation. MRI diagnosis of vertebral body destruction, disc involvement, paravertebral abscess and spinal involvement is superior to plain radiography and CT (P <0.05). Conclusion: MRI is highly sensitive to the pathological changes of vertebral body and makes the early diagnosis of spinal tuberculosis possible. MRI can clearly show the vertebral tuberculosis of vertebral osteitis, paravertebral abscesses, endplate destruction and involvement of spinal stenosis, and contribute to the identification of vertebral tumors.