成人椎间盘炎的MRI诊断

目的 评价MRI对成人椎间盘炎的诊断价值。方法 搜集经临床证实的28例椎间盘炎患者的MR影像资料，分析其MRI表现，比较各种成像方法的敏感性与特异性及其在鉴别诊断中的价值。MRI检查使用1．0T超导机，T1、T2加权像及脂肪抑制T2加权像，2例进行了增强检查。结果 75％的病变椎间盘呈不均匀长T2高信号；全组病例均有相邻椎体受累，两个及两个以上受累者达89％。病变椎体均呈显著长T1低信号，25例呈不均匀长T1高信号，脂肪抑制T2加权像上高信号改变更明显。5例可见椎体边缘骨质增生。椎体受累范围大于二分之一者达78．5％。5例椎体边缘骨质破坏、不完整，而82．1％的病变椎体均无明显外形改变。12例椎旁或椎管内可见局限性脓肿影。2例行Gd—DTPA增强后均可见椎间盘及病变椎体内显著异常强化。结论 MRI对成人椎间盘炎具有极高的敏感性与特异性，可准确鉴别本病与椎体结核与肿瘤，是临床上应作为首选的影像检查方法。

MR imaging in the diagnosis of adult discitis

Objective To demonstrate the diagnostic value of MR imaging in the adult discitis. Methods Twenty- eight patients with clinically confirmed discitis were retrospectively studied through reviewing the MR images and comparing the sensitivity and differential diagnostic values of different imaging techniques. Sagittal and axial T1 and T2 weighted images were taken with spin echo or turbo spin echo sequences in all cases, Fat saturation T2 weighted sagittal images were applied in some cases and Gd- DTPA enhancement were applied in two cases. Results 75 % of the affected discs were inhomogeneously hyperintensity on T2 weighted images. Vertebral body invasion can be confirmed in all cases and 89% cases with two or more vertebral bodies were involved. All of the involved vertebral bodies were predominently hypointensity on T1 weighted images but only 25 cases revealed inhomogeneously hyperintensity on T2 weighted images. On fat saturation T2 weighted images, the hyperintensive areas were much more evident. In 5 cases, ossification in the vertebrae could be observed. In 78.5% cases, more then half a vertebral body were involved. Only in 5 cases, the vertebrae were destroyed with irregular margins, the rest 82.1% cases had no any abnormal changes in the vertebrae shape. Paravertebral or intraspinal canal abscesses can be seen in 12 cases. With Gd- DTPA enhanced T1 weighted images, 2 cases revealed abnormal enhancement in the discs and vertebral bodies. Conclusion MR imaging is the most useful method for diagnosing adult discitis and it can accurately differentiate it from spinal TB or tumors.