脊柱结核CT和MRI影像学特征比较研究

目的研究脊柱结核在CT和MRI中的影像特征及其比较价值,提升脊柱结核的诊断水平。方法选择我院2014年1月-2015年6月经过利福平和异烟肼等抗结核药物治疗有效果和手术之后具有病理结果的30例脊柱结核患者采用回顾性方法进行分析,观察脊柱结核的CT和MRI影像征象。结果 2例颈椎结核,6例胸椎结核,7例胸腰椎结核,10例腰椎结核,3例腰骶椎结核,2例骶椎结核。脊柱结核在CT扫描表现为溶骨性、虫蚀状、碎骨片状骨质破坏并伴有硬化,椎管受累,冷脓肿的形成,椎间隙变窄等,其中椎旁软组织中可见砂粒样钙化;脊柱结核在MRI扫描表现为椎骨质破坏,椎旁脓肿形成,椎间盘破坏,椎管受累等,其中破坏区周围见不同程度的水肿区。结论结合CT和MRI的在影像检查中各自存在的优越性,采用两种检查方法相结合的方式能够全面呈现出脊柱结核的影像学特点,大大的提高了脊柱结核的确诊率,更易于脊柱结核和其他具有相似病症的疾病的区分,降低漏诊率和误诊率,具有一定的临床价值和意义。

Imaging Features Comparison of CT and MRI on Spinal Tuberculosis

Objective To investigate the imaging features and value of CT and MRI on spinal tuberculosis to improve diagnosis ability. Methods 30 cases given rifampicin and isoniazide in our hospital from January 2014 to June 2015 were selected and retrospectively analyzed. Observe the imaging features and detection rate of CT and MRI on spinal tuberculosis. Results There were 2 cervical tuberculosis, 6 thoracic spinal tuberculosis, 7 thoracolumbal tuberculosis, 10 thoracolumbal tuberculosis, 3 lumbosacral vertebral tuberculosis, and 2 sacral vertebral tuberculosis. Spinal tuberculosis CT scan showed osteolytic bone, moth-eaten, bone destruction and harden, spinal canal involved, cold abscess and intervertebral space narrowing, paravertebral soft tissue can see grit calcification. Spinal tuberculosis MRI scan showed bone destruction, paravertebral abscess, intervertebral disc damage and spinal canal involvement. Conclusion The combination of CT and MRI can comprehensively present imaging features of spinal tuberculosis, greatly improved diagnosis rate, lower the missed diagnosis and misdiagnosis rate. It has certain clinic value and significance.