脊柱结核的MRI表现

目的探讨脊柱结核的MRI表现特征。方法回顾性分析38例经手术病理证实的脊柱结核患者的MRI资料。结果(1)38例患者101个椎体受累,单椎体5例,2个椎体13例,3个椎体12例,4个椎体以上8例。T1WI呈均匀低信号37个,混杂低信号61个,等信号3个。T2WI及T2/SPIR呈均匀高信号34个,混杂高信号63个,等信号4个。增强扫描呈不均匀强化。(2)29例45个椎间盘受累,椎间隙狭窄27个,椎间隙消失18个。T1WI呈低信号,T2WI及T2/SPIR呈不均匀高信号。(3)27例寒性脓肿形成,其中25例为椎体前缘或周围脓肿,5例伴腰大肌脓肿,14例见椎管内脓肿。脓肿T1WI呈稍低信号,T2WI及T2/SPIR呈明显高信号,增强扫描呈不均匀强化或环形强化。(4)12例患者19个椎弓根受累;19例脊髓受压。结论脊柱结核病变具有多样性,病变可累及椎体的各部位,MRIT1WI及T2WI以混杂信号为主,综合分析有助于诊断和鉴别诊断。

MRI Characteristics of Spinal Tuberculosis

Objective To explore MRI characteristics of spinal tuberculosis.Methods MRI of 38 patiens with spinal tuberculosis proved pathologically was analyzed retrospectively. Results (1) 101 vertebrates were involved in 38 patients . Only one vertebrate was involved in 5 of 38 cases, two vertebrates were involved in 13 of 38 cases; three vertebrates were involved in 12 of 38 cases; more than 4 vertebrates were involved in 8 of 38 cases. On T_1WI, hypointense was showed in 37 vertebrates, mixed hypointense in 61 vertebrates and isointense in 3. On T_2WI and SPIR , 34 vertebrates showed hyperintense and 63 with mixed hyperintense ; (2) 45 spinal discs had the pathological changes in 29 cases, T_1WI showed low signal intensity,T_2WI and SPIR showed mixed high signal intensity ; (3) 27 patients showed "cold abscess", 25 of 27 were around vertebrates, 5 of 25 with the abscess in psoas major muscle and 14 of 25 with abscess in vertebrate cavity. The absecess showed low signal intensity on T_1WI,hyperintense on T_2WI and SPIR. Enhanced scanning showed irregular or circular enhancement ; (4) 12 patients showed abnormal signal in 19 vertebral arches. Spinal cords were pressed in 19 patients . Conclusion Spinal tuberculosis have multiple characteristics on MRI, the lesions have different locations.T_1WI and T_2WI often showe mixed signal,these are helpful to the diagnosis and differential diagnosis of the spinal tuberculosis.