CT与MRI对脊柱结核的诊断价值

目的探究CT与MRI对脊柱结核的临床诊断价值。材料与方法回顾性分析经手术病理、穿刺活检及随访证实的110例脊柱结核的完整临床及影像资料,所有病例均行CT及MRI平扫检查,部分同时行增强检查。结果颈椎9例,胸椎25例,腰椎42例,胸腰段31例,骶椎3例。脊柱结核CT主要表现为椎体及附件骨质破坏、椎旁脓肿、死骨、钙化等;脊柱结核MRI主要表现为椎体和附件骨破坏、椎间盘信号变化、椎旁脓肿、硬膜囊和脊髓受累、韧带的扩散等;CT对死骨及钙化的显示优于MRI,二者差异具有统计学意义(P=0.00);MRI对骨髓水肿、硬膜囊及脊髓受累、韧带下播散的显示优于CT,二者差异具有统计学意义(P=0.00)。结论脊柱结核表现各种各样,CT和MRI对脊柱结核的诊断都有很高的价值,CT对死骨及钙化的显示更有优势,MRI在显示早期病变、硬膜囊及脊髓受累、韧带下播散等更有优势,二者联合有助于脊柱结核的诊断及与其他疾病的鉴别。

The diagnostic value of CT and MRI in spinal tuberculosis

Objective:To explore the diagnostic value of CT and MRI in spinal tuberculosis.Materials and Methods:One hundred and ten cases with spinal tuberculosis conifrmed by the surgical operation pathology, needle biopsy and follow-up received Computed Tomography and MRI plain scan, at the same time, some cases received enhance scan.Results:One hundred and ten cases of spinal tuberculosis (TB), including 9 cases of cervical vertebra, 25 cases of thoracic vertebra, 42 cases of lumbar vertebra, 31 cases of thoracic lumbar vertebra and 3 cases of the sacral vertebra. The CT features of spinal tuberculosis are the bone destruction of vertebral body and accessories, the formation of vertebral abscess, sequestrum, calciifcation and spinal canal stenosis, etc. The MRI features of spinal tuberculosis are MRI of spinal tuberculosis are the bone destruction of vertebral body and accessories, the destruction of intervertebral disc, the formation of vertebral abscess, the invasion of dural and myeloid, the diffusion of sub-ligament, etc. The CT in diagnosing sequestrum and calciifcation was signiifcantly higher than MRI(P=0.00), but the MRI in diagnosing the bone marrow edema, the invasion of dural and myeloid, the diffusion of sub-ligament was significantly higher than CT(P=0.00).Conclusion:The features of Spinal tuberculosis are diversiifed, CT and MRI has high value in diagnosis of spinal tuberculosis, CT has the advantage in showing sequestrum and calciifcation and MRI has the advantage in showing the early stages of dieases, the invasion of dural and myeloid, the diffusion of sub-ligament, such as a combination is helpful to diagnosing and differential diagnosing of spinal tuberculosis.