脊柱结核磁共振成像增强扫描的意义

目的通过分析脊柱结核的磁共振成像(magnetic resonance imaging,MRI)影像表现,提高对脊柱结核的诊断、认识。材料与方法回顾性分析经活检和手术病理检查证实的57例脊柱结核患者的MRI影像资料,分析脊柱结核MRI平扫及增强扫描影像表现。结果 57例患者中颈椎结核5例、胸椎结核12例、腰椎结核24例,颈椎合并胸椎3例,胸椎合并腰椎8例,腰椎合并骶椎5例。单椎体受累2例,相邻2个椎体受累41例,3个及3个以上椎体受累14例。43例椎间隙狭窄或消失,40例脓肿形成。增强扫描41例病灶区域明显强化,16例弱强化或无强化。57例患者均接受1~3月不等强化多联抗结核化疗治疗。15例患者术前多次行MR增强扫描检查,12例患者影像学表现不同程度好转,3例无明显变化。结论 MRI增强扫描对早期诊断脊柱结核及指导临床治疗有着重要的应用价值。

The significance of MRI enhanced scan in the spinal tuberculosis

Objective: To improve the diagnosis of spinal tuberculosis by analyzing the MRI imaging findings of spinal tuberculosis. Materials and Methods: MRI imaging data of 57 patients with spinal tuberculosis confirmed by biopsy and surgery and pathology were analyzed retrospectively. The findings of MRI plain scan and enhanced scan images of spinal tuberculosis were analyzed. Results: Fifty-seven cases of cervical tuberculosis in 5 cases, 12 cases of thoracic tuberculosis, 24 cases of lumbar spine tuberculosis. Cervical vertebrae complicating thoracic vertebrae were 3 cases. Thoracic vertebrae complicating lumbar were 8 cases. Lumbar complicating sacral vertebrae were 5 cases. Only one vertebrae was involved in 2 cases, two vertebraes were involved in 41 cases, more than three vertebraes were involved in 14 cases. There were stenosis or disappearance of intervertebral space in 43 cases and 40 cases had cold abscess. There were obviously enhanced in 41 cases and weak or no enhanced in 16 cases by MR enhanced scan. 57 patients were treated with 1-3 months by the combination of multiple anti-tuberculosis chemotherapy. MR scan was performed more than 2 times in 15 patients before operation. 12 patients' imaging performances were better than that of anti-tuberculosis chemotherapy and 3 cases were not. Conclusion: MRI enhanced scan has important application value in diagnosis and treatment of spinal tuberculosis.