多层螺旋CT在脊椎泡状棘球蚴病中的诊断价值

目的探讨多层螺旋CT(multi-slice CT,MSCT)在脊椎泡状棘球蚴病中的诊断价值。方法对2009年10月～2018年6月在我院经手术病理证实的10例脊椎泡状棘球蚴病的MSCT和临床资料进行分析,重点观察椎体病变部位、破坏形态、钙化死骨形成、椎间隙改变及椎旁软组织受累情况。结果 10例脊椎泡状棘球蚴病中,胸椎6例,胸腰椎3例,腰椎1例。7例相邻多椎体和3例单椎体共19个椎体破坏。MSCT扫描6个(31.6%)椎体呈蜂窝样、小囊状骨质破坏,11个(57.9%)呈斑片状溶骨性骨质破坏,2个(10.5%)椎体骨皮质局限性侵蚀。12个(63.2%)椎体病变周围片状骨质硬化。7个(36.8%)椎体破坏灶内死骨、钙化形成。9个(47.4%)椎弓骨质膨胀性破坏。5个(26.3%)椎间盘破坏和椎间隙变窄。10例椎旁软组织增厚,7例呈囊性,2例呈囊实性,1例呈实性;7例出现结节、沙粒样钙化。结论多层螺旋CT扫描能够明确脊椎泡状棘球蚴病的病变部位并显示病变特征,对该病的诊断和临床指导具有重要价值。

Diagnostic value of multi-slice spiral CT in vertebral alveolar echinococcosis

Objective?To investigate the diagnostic value of multi-slice CT(MSCT)in vertebral alveolar echinococcosis.Methods?The MSCT and clinical data of 10 cases of vertebral alveolar echinococcosis confirmed by operation and pathology in our hospital from October 2009 to June 2018 were analyzed.The focus was on vertebral lesions,destruction morphology and calcified bone formation,changes in intervertebral space and involvement of paravertebral soft tissue.Results?Among 10 cases of vertebral alveolar echinococcosis,6 cases of thoracic vertebrae,3 cases of thoracolumbar vertebrae and 1 case of lumbar vertebrae.A total of 19 vertebral bodies were destroyed in 7 adjacent vertebral bodies and 3 single vertebral bodies.MSCT scanned 6(31.6%)vertebral bodies with honeycomb-like and small cystic bone destruction,11(57.9%)with patchy osteolytic bone destruction,and 2(10.5%)with vertebral cortical limitations erosion,12(63.2%)with vertebral sclerosis around vertebral lesions.Seven(36.8%)had dead bone and calcification in destroyed vertebral bodies.Nine(47.4%)vertebral arch bones were expansively disrupted.Five(26.3%)had disc destruction and narrow intervertebral space.Ten cases of paravertebral soft tissue were thickened,7 cases were cystic,2 cases were cystic,and 1 case was solid.7 cases had nodules and sand-like calcification.Conclusion?Multi-slice spiral CT scan can identify the lesions of the telangiectal echinococcosis and show the characteristics of the lesions,which is of great value in the diagnosis and clinical guidance of the disease.