多层螺旋CT及多平面重组在脊柱结核诊断中的应用

Value of multilayer helic CT and multi-panar reconstruction in diagnosis of spinal tuberculosis

目的探讨多层螺旋CT及多平面重组在脊柱结核诊断中的应用价值。方法回顾分析间经多层螺旋CT及多平面重组检查诊断,并经临床、手术及病理检查证实的125例脊柱结核。结果125例脊柱结核中多层螺旋CT及多平面重组共显示累及颈椎者5例,占4%,累及颈胸段者2例,占1.6%,累及胸椎者29例,占23.2%,累及胸腰段者10例,占8%,累及腰椎者72例,占57.6%,累及腰骶段者7例,占5.6%。其中125例骨质破坏,27例死骨形成,75例椎旁或腰大肌脓肿,78例椎间盘破坏,35例骨性椎管狭窄。结论脊柱结核的传统X线检查,有其明显局限性,多层螺旋CT及多平面重组可清晰显示骨质破坏的细节,死骨、脓肿及钙化的形成,椎间盘的破坏,对病变范围、椎管狭窄及脊髓压迫的情况有明显的显示优越性。这二者的结合已成为目前脊柱结核的有效影像诊断方法。

Objective To evaluate the value of multilayer helic CT and multi-panar reconstruction in diagnosis of spinal tuberculosis.Methods To analyze the findings of multilayer helic CT and multi-panar reconstruction of one hundred and twenty-five cases of spinal tuberculosis confirmed by operation,pathology and clinic symptom.Results In 125 cases,the lesion located in cervical vertebrae had 5 cases（4%）,2 cases in cervicothoracic spinal tuberculosis（1.6%）,29 cases in thoracic spinal tuberculosis（23.2%）,10 cases in thoracolumbar spinal tuberculosis（8%）,72 cases in lumbar spinal tuberculosis（57.6%）,7 cases in lumbarsacrum spinal tuberculosis（5.6%）.All of 125 cases had bone destruction,27 cases had sequsetrum,75 cases had soft tissue masses,78 cases had vertebral disc destruction,35 cases had spinal canal stenosis.Conclusion The X-ray of spinal tuberculosis have localization,multilayer helic CT and multi-panar reconstruction have clear findings of bone destruction,sequsetrum,tissue masses and calcification and vertebral disc destruction,they also have the obvious superiority in the area of lesion,spinal canal stenosis and the oppression of spinal cord.The connection of multilayer helic CT and multi-panar reconstruction have been the effective technique in diagnosis of spinal tuberculosis.