摘要
目的:探讨MRI对不典型脊椎结核的诊断价值。方法:回顾性分析21例经手术病理证实的脊椎结核患者的影像资料。结果:21例脊椎结核患者,术前行X线检查21例,CT检查19例,MRI检查21例;14例X线平片及10例CT检查阴性;7例X片示单椎体破坏区位于椎体后缘,呈溶骨性破坏、压缩骨折;9例CT显示相邻椎体病变,椎间盘变窄、椎体无明显破坏;无多个椎体跳跃破坏,椎小关节受累、椎旁软组织肿块内未见明确脓肿形成;MRI检查21例中,20例显示病变椎体呈长T1长T2信号,抑脂序列呈不均匀高信号,16例显示椎间隙变窄,间盘裂隙状强化,17例显示椎旁脓肿,以上20例确诊为椎体结核。1例MRI显示椎旁软组织肿块内无脓肿形成,疑诊为肿瘤。结论:MRI对不典型脊椎结核诊断敏感度、特异度及准确性均高于其他影像检查,能为临床提供更有价值的信息。
Objective：To study the value of MRI in the diagnosis of atypical spinal tuberculosis. Methods：The imaging materials of 21 cases with surgery and pathology proven tuberculosis of spine were collected and retrospectively analyzed. Results：Of the 21 cases,imaging examinations included radiography （21 cases ）,CT （19 cases） and MRI （21 cases）. 14 cases with X-ray plain film and 10 cases with CT shown negative results before surgery. 7 cases showed osteolytic destruction and compressed fracture at the posterior margin of vertebral body in one single spine on X-ray films. Adjacent consecutive vertebral lesions,narrowing of inter-vertebral discs yet without obvious vertebral body destruction were assessed in CT of 9 cases. No multiple skipping vertebral body destruction, inter-vertebral joint involvement and obvious abscess formation within para-spinal soft tissue mass was revealed. 21 cases were examined by MRI,20 cases having MRI,long T1 and long T2 signal intensities and heterogeneous hyper-intensities of vertebral bodies on fat-suppression sequence were assessed. Narrowing of inter-vertebral space, slit-like enhancement of inter-vertebral discs could be seen in 16 cases. Paravertebral abscess fomation could be seen in 17 cases,spinal tuberculosis was diagnosed in above 20 cases. One case had no abscess formation within the paraspinal soft tissue mass and was suspected of having tumor. Conclusion：The sensitivity, specificity, accuracy of MRI is superior to other imaging modalities in the diagnosis of atypical spinal tuberculosis, MRI provides valuable information in clinical application.
出处
《放射学实践》
北大核心
2009年第1期83-86,共4页
Radiologic Practice
关键词
结核
脊柱
磁共振成像
体层摄影术
X线计算机
Tuberculosis, spine
Magnetic resonance imaging
Tomography, X-ray computed
