脊柱结核的MRI表现特点及诊断价值分析

目的探讨脊柱结核的磁共振(MRI)表现特点及诊断价值。材料与方法选取67例本院既往诊断的脊柱结核患者(结核组)、40例非脊柱结核性脊柱疾病患者作为对照组,回顾性分析两组患者的X线平片、CT、MRI影像学资料,探讨脊柱结核的MRI表现特点及诊断价值。结果 67例患者,共累及162个椎体,其中累及腰椎的患者有30例(44.77%)、累及腰椎椎体80个(49.38%);累及的162个椎体中,MRI下主要表现为骨质破坏的有62例(92.54%)、脓肿形成57例(85.07%)、终板破坏52例(77.61%);MRI对骨质破坏、椎间盘受累的检出率均达到100%;MRI对骨质破坏、终板破坏、椎间盘受累、脓肿形成、椎管受累、死骨形成的检出率显著的高于X线、CT(P0.05),MRI对钙化情况的检出率低于CT的检出率(P0.05);MRI诊断脊柱结核的灵敏度为92.54%、特异度为87.50%;CT诊断脊柱结核的灵敏度为68.66%、特异度为82.50%;X线平片诊断脊柱结核的灵敏度为47.76%、特异度为70.00%。结论 MRI对脊柱结核患者的各项特征早期检出率均较高,诊断脊柱结核患者的效能显著地优于X线和CT。

MRI features and diagnostic value of spinal tuberculosis

Objective: To explore MRI characteristics and diagnostic value of spinal tuberculosis. Material and Methods: Sixty-seven cases of patients previously diagnosed with spinal tuberculosis in our hospital were selected as TB group, 40 patients who have spinal disease with non-tuberculous were selected as control group, the X-ray, CT, MRI imaging data of the two groups were analyzed respectively to explore the MRI characteristics and diagnostic value of spinal tuberculosis. Results:Sixty-seven patients involved a total of 162 vertebrae, among which 30 patients involved with lumbar spine cases (44.77%), involving 80 lumbar vertebrae (49.38%), among the 162 vertebral body involvement, MRI showed bone destruction in 62 cases (92.54%), abscess formation in 57 cases (85.07%), endplate damage in 52 cases (77.61%). The detection rate of MRI in bone destruction, disc involvement is 100%. In bone destruction, endplate damage, disc involvement, abscess formation, spinal involvement and sequestration, the detection rate of MRI is significantly higher than the X-ray, CT (P <0.05), MRI detection rate of calcification is lower than CT detection rate (P<0.05). The sensitivity of MRI in diagnosing spinal tuberculosis is 92.54%, the specificity is 87.50%. The sensitivity of CT in diagnosing spinal tuberculosis is 68.66%, the specificity is 82.50%. The sensitivity of X-ray in diagnosing spinal tuberculosis is 47.76% and the specificity is 70.00%. Conclusions: The detection rate of MRI in diagnosing the early characteristics of spinal tuberculosis is higher, which is significantly better than X-ray and CT in diagnosing patients with spinal tuberculosis.