椎间盘炎的MRI诊断及临床表现

目的探讨椎间盘炎的MRI表现。方法对36例经临床及手术病理证实的椎间盘炎患者行MRI检查,矢状位及轴位FSE序列T1WI、T2WI及STIR序列,其中6例行Gd-DTPA对比增强扫描,分析其MRI表现。结果36例中44个椎间盘炎,其中43个椎间隙变窄,椎间盘不同程度破坏、碎裂,1个椎间隙变化不明显;39个椎间盘T1WI呈低信号,5个呈等信号;41个椎间盘T2WI呈高信号,3个呈低信号;42个椎间盘"髓核征"阳性;44个椎间盘相邻椎体不同程度受累破坏;22个椎间盘炎有椎旁软组织脓肿。6例行Gd-DTPA对比增强扫描显示病变椎间盘、相邻椎体及椎旁软组织明显异常强化。结论椎间盘炎的MRI表现具有特征性,MRI应作为其首选的影像学检查方法。

MRI Diagnosis and Clinical Manifestations of Discitis

Objective To discuss the MRI findings and clinical characteristics of discitis.Methods MRI was performed in 36 cases with clinically or pathologically proved discitis.Both sagittal and axial FSE T1WI,T2WI and STIR scanning were carried out in all cases,Gd-DTPA enhanced scaning was done in 6 cases,MR imaging findings were analysed.Results 44 discitis in 36 cases were involved.The disc involved appeared as narrowing of intervertebral space,destruction and rupture in 43 discs,no obvious change of the intervertebral space in 1;low signal intensity in 39 and iso-signal intensity in 5 on T1WI ;high signal intensity in 41 and low signal intensity in 3 on T2WI;the positive intranuclear cleft sign in 42 discs;the adjacent vertebral bodies were involved and destroyed in different degree in 44 discs;abscess of paraspinal soft tissue was seen in 22.Obviously abnormal enhancement of the diseased disc,adjacent vertebral bodies and paraspinal soft tissue after Gd-DTPA injection was found in 6 cases.Conclusion Discitis is of typical MRI appearances,MR imaging is the first examination for discitis.