脊椎结核与脊椎转移瘤的CT形态差异

目的:探讨脊椎结核与脊椎转换瘤的CT形态差异。材料和方法:回顾性分析和比较27例脊椎结核和24例脊椎转移瘤的CT表现,拟定出两类病变的CT形态差异指标进行鉴别诊断。结果:脊椎结核多发生于椎体前中部、多以多发及弥散形式出现,病灶内可有死骨;脊椎转移瘤多以单发形式出现,多发生于椎体中后部和附件骨、病灶内少有死骨;结核的椎旁肿块常有钙化、多无强化或仅周边强化,而转移瘤的椎旁肿块少有钙化但强化明显;结核常累及椎间盘和相邻椎骨,而转移瘤罕有累及椎间盘和相邻椎骨。结论:上述CT形态差异指标的应用,有助于脊椎结核与脊椎转移瘤的鉴别诊断。

Vertebral Tuberculosis versus Vertebral Metastases:Differences of CT Appearances

Purpose: To research morphological difference of vertebral tuberculosis and vertebral metastases by means of CT. Materials and Methods: The CT appearaces of 27 patients with vertebral tuberculosis and 24 patients with vertebral metastases were retrospectively analysed. The CT differential criteria of the two categories of diseases was developed. Results: Reliable criteria for vertebral tuberculosis were anteriomedial portion involvement of vertebra, multiple or diffuse bone destruction, presence of sequstra within lesion, calcification within paravertebral mass, no enhancement or only edge enhancemant of paravertebral mass, and involvement of intervertebral disc and contiguous vertebral. Vertebral metastases wewe characterized by posteriomedial portion involvement of vertebra, single bone destrution, obvious enhancement of paravertebral mass, absence of sequestra within lesion, no calcification within paravertebral mass, normal intervertebral disc, and no involvement of contiguous vertebra. Conclusion: The application of the differential criteria indicated potentia for improving diagnostic accuracy in diagnosis of vertebral tuberculosis and vertebral metastasis.