摘要
目的探讨脊柱结核与非结核性脊柱炎的MRI鉴别诊断价值。方法搜集2010年1月至2014年4月间我院脊柱感染性病变者53例,经手术、穿刺活检病理检查证实为结核33例及化脓性炎症18例,病原学检查证实为布鲁氏菌性脊柱炎2例,由两位有经验的影像诊断医师共同分析所有病例的MRI特征。结果 53例脊柱感染性病例中,累及多椎体52例,累及单椎体1例;共累及椎体139个,其中颈椎16个,胸椎44个,腰椎72个,骶椎7个;脊柱结核较其他感染性脊柱炎更易造成椎体塌陷畸形、椎间盘狭窄及破坏、死骨或钙化形成多,较易形成椎旁蔓延性脓肿及硬膜外脓肿蔓延;化脓性脊柱炎较易形成局限性椎旁脓肿或肉芽肿,均不超过椎体病变范围;布氏杆菌性脊柱炎有明显骨质增生,椎间盘受累不明显。结论根据观察MRI上病变椎体及其周围组织受累情况,结合临床,有助于脊柱结核与非结核性脊柱炎的鉴别。
Objective To investigate the value of MRI imaging in differential diagnosis of spinal tuberculosis and non tuberculosis spondylitis. Methods 53 cases of infectivity rachitis confirmed by pathology were collected from January2010 to April 2014,33 were spinal tuberculosis,18 were pyogenic spondylitis,the rest 2 were spondylitis caused by brucells infection,and were analyzed their radiological characteristics by two experienced radiologists. Results Of the 53 cases,except 1 case involve single vertebrae,the other 52 cases were multi- vertebrae involved,the 139 damaged vertebraes include 16 cervical vertebrae,44 thoracic vertebrae,72 lumbar vertebrae and 7 sacral vertebrae. Tuberculous spondylitis were more likely to cause vertebral deformities,intervertebral disc stenosis and destruction,sequestrum calcification,and more vulnerable to the formation of paravertebral spread abscess and epidural abscess spreading. Pyogenic spondylitiseasily form limited paravertebral abscess or granuloma,but the range was relatively smaller than tuberculosis spondylitis,seldom exceed the scope of vertebral lesions. Brucella spondylitis had significant hyperosteogeny,Intervertebral disc involvement was not obvious. Conclusion According to observation on the vertebral lesions and surrounding tissue involved on MRI iamging,combined with clinical,are helpful to differentiate tuberculous spondylitis from other non tuberculosis spondylitis.
出处
《临床放射学杂志》
CSCD
北大核心
2015年第6期960-966,共7页
Journal of Clinical Radiology
关键词
脊柱感染
结核性脊柱炎
化脓性脊柱炎
磁共振成像
Vertebral infection Tuberculous spondylitis Pyogenic spondylitis Magnetic resonance imaging
