化脓性脊椎炎的MRI诊断

目的:探讨MRI对化脓性脊椎炎的诊断价值。方法:回顾分析12例经手术病理或临床证实的化脓性脊椎炎的MRI表现。所有病例均行SE序列T1WI、T2WI扫描和短时反转恢复(STIR)序列扫描,2例同时行Gd-DTPA增强扫描。结果:12例共累及27个椎体,14个椎间盘。9例发生在腰椎,1例胸腰椎,2例腰骶椎。6例12个椎体为相邻椎体终板下局限长T1、长T2信号改变;另6例15个椎体为全椎弥漫性长T1、长T2信号改变,椎体未见明显塌陷。14个受累椎间盘也以长T1、长T2信号为主,9例椎间隙变窄。12例均有不同程度椎旁软组织肿胀、增厚,5例累及硬膜外间隙。2例Gd-DTPA增强扫描病变椎体、椎间盘、椎旁软组织明显异常强化。结论:MRI对全面显示化脓性脊椎炎的椎体、椎间盘的破坏程度、范围,周围软组织肿胀及椎管内累及的敏感性、准确性较高,具有明显优势,可作出早期诊断。

MRI in Diagnosis of Pyogenic Spondylitis

Objective:To evaluate the value of MRI in the diagnosis of pyogenic spondylitis(PS).Methods:MRI fings in 12 patients with pathologically or clinically confirmed PS were retrospectively analyzed.SE T_1WI,T_2WI and STIR were carried out in all cases.Gd-DTPA enhanced scanning was performed in 2 cases.Results:Of 12 cases,27 vertebral bodies and 14 intervertebral discs were involved.The lesions developed at lumbar spines in 9 cases,both thoracic and lumbar spins in 1 and both lumbar spins and sacrum in 2 cases.localized long T_1 and long T_2 signals in adjacent sub-endplate of vertebral bodies showed in 12 vertebral bodies of 6 cases,diffused long T_1 and long T_2 signals in other 15 vertebral bodies of 6 cases.The involved intervertebral discs displayed mainly long T_1 and long T_2 signal.Tumefaction of paravertebral soft tissue at varied degrees showed in 12 cases,extradural space was involved in 5 of 12 cases.Obviously abnormal enhanced vertebral bodies,intervertebral discs and paravertebral soft tissues after Gd-DTPA injection showed in 2 cases.Conclusion:MRI was sensitive and accurate in the early diagnosis of PS.