椎间隙感染的MRI诊断

目的：分析椎间隙感染的MRI影像特征，评价椎间隙感染的MRI诊断价值。方法：对15例经临床或手术病理证实的椎间隙感染患者行脊柱MRI检查，扫描序列为矢状面FrFsE-T1WI、FrFSE-T2WI、脂肪抑制T2WI，横断面FrFSE-T2WI，其中5例行Gd-DTPA增强对比扫描。结果：15例患者共发现17个椎间隙感染，其中15个发生于腰椎间隙。椎间隙狭窄(13个)，病变椎间盘呈不同程度破坏、碎裂，呈长T1(17个)长T2(15个)信号，T2上椎间盘髓核内正常裂隙状低信号消失(13个)，上下相邻椎体受累破坏(15个)，椎旁软组织肿胀(8个)。5例行Gd-DT-PA增强对比扫描可见病变椎间盘、相邻椎体及椎旁软组织异常强化。结论：MRI对诊断椎间隙感染具有很高的敏感性和准确性，应作为首选的影像学检查方法：

MRI Imaging of lntervertebral Infection

Objective:To analyze MR imaging features of intervertebral infection and evaluate MR imaging value in the diagnosis of intervertebral infection.Methods:15 patients with clinically or pathologically proven intervertebral infections underwent the spine MRI.Sagittal FrFSE T 1-and T 2-weighted images,T 2-weighted images with fat-suppression and axial FrFSE T 2-weighted images were obtained in all cases,and contrastenhanced MRI were ordered in 5 patients.Results:17 intervertebral infections were detected in 15 patients.The lesion sites of 15 intervertebral infections were lumbar discs.MRI findings disclosed:(1)Narrowed intervertebral space(n=13) and destruction and rupture of the discs to varying degrees,which showed low-signal-intensity on T 1-weighted images (n=17) and high-signal-intensity on T 2-weight images (n=15).The normal crack shaped short T 2 signal in nucleus pulposus disappeared(n=13).(2)The adjacent vertebral bodies were involved and destroyed to varying degres and had long T 1 and T 2 relaxation times because of edema and congestion (n=15).(3)Swollen paravertebral soft tissues were observed (n=8).(4)In five patients,abnormal enhancement of the diseased discs,adjacent vertebral bodies and paravertebral soft tissues were found after Gd-DTPA administration.Conclusion:Compared with plain film or CT scanning,MRI is a technique with high sensitivity and accuracy for diagnosing intervertebral infection,and it is recommendable as the first choice of imaging procedure in the diagnosis of intervertebral infection.