脊椎结核的CT、MRI表现和评价

目的探讨脊椎结核的CT、MRI表现及在诊断中的价值。方法回顾性分析经病理证实的34例脊椎结核病人资料，CT20例，MR124例，其中10例病人进行了MRI、CT两项影像学检查，结果进行相互比较。结果脊椎结核CT表现为骨质破坏、椎旁脓肿形成、死骨或钙化、椎管受累等；MRI表现为骨质破坏、骨髓水肿、椎间盘破坏、椎旁脓肿形成、椎管受累、韧带下播散等。结论脊椎结核病变具有多样性，CT和MRI表现各有特点，CT在显示死骨、钙化等方面具有优势，而MRI在显示骨髓水肿、韧带下播散，硬膜及脊髓侵犯等方面具有优势，两者综合分析有助于脊椎结核的诊断和鉴别诊断。

Diagnosis of spinal tuberculosis with CT and MRI

Objective To explore CT and MRI findings of spinal tuberculosis and evaluate the diagnostic value of them. Methods 34 patients with spinal tuberculosis proved by pathology were retrospectively analyzed. Among these patients, 20 cases were examined by CT and 24 cases were examined by MRI. 10 cases were examined by both CT and MRI. Results Spinal tuberculosis CT findings were bone destruction, paraspinal abscess, sequester or calcification and spinal canal involvement. Spinal tuberculosis MRI findings were bone destruction, marrow edema, intervertebral disc destruction, paraspinal abscess, spinal canal involvement and subligamental spread. Conclusion There are multiple characteristics of spinal tuberculosis with CT and MRI. CT is better for sequester and calcification and MRI is better for marrow edema, subligamental spread, epidural and spinal cord involvement. Analyzing CT and MRI manifestations are helpful to make a diagnosis and differential diagnosis of the spinal tuberculosis.