CT与MRI在诊断脊柱结核中的各自优势

Respective advantage of CT and MRI in diagnosing spine tuberculosis

目的研究CT、MRI与脊柱结核(STB)临床分型的符合率,并比较这两种技术各自的诊断优势。方法 60例由手术病理证实的STB患者均经CT与MRI检查。CT、MRI与STB临床分型符合率及其各自的诊断优势,是采用SPSS 12.0统计软件与卡方检验对比分析的。结果在60例患者的临床4型中,CT与MRI诊断中心型分别为6和8例,边缘型分别为24和26例,韧带下型分别为16和14例以及附件型分别为14和12例,两种技术诊断STB与临床分型符合率比较,无显著性差异(P>0.05)。MRI诊断硬膜与脊髓侵犯以及韧带下播散的敏感性明显高于CT(P<0.05),而CT诊断死骨与钙化的敏感性明显高于MR(IP<0.05)。结论 CT与MRI诊断STB可实现优势互补,但为了遵循国际原子能机构(IAEA)倡导的辐射防护最优化原则,在临床实践中,应尽可能做到二者择一。

Objective To study the corresponding rate between CT and MRI diagnosis with clinical classification of spine tuberculosis（STB） and to compare the respective advantage of the two techniques.Methods Sixty patients with surgically and pathologically proved STB underwent CT and MRI examinations.The comparison between CT and MRI diagnosis with clinical typing of STB and their advantage was performed by using SPSS 12.0 statistic software and chi-square test.Results Among four clinical types of 60 patients,centre type seen on CT and MR images was respectively found in 6 and 8,border type in 24 and 26,sub-ligamental diffusion type in 16 and 14,and accessory type in 14 and 12 cases.The comparison of the corresponding rate between CT and MRI was not significant difference（P 0.05）.The sensitivity of MRI in diagnosing dural and myeloid invasion as well as sub-ligamental diffusion was significantly higher than that of CT（P 0.05） but the sensitivity of CT in diagnosing sequestrum and calcification was significantly higher than that of MRI（P 0.05）.Conclusion CT and MRI in diagnosing STB may realize their advantage complementarity but the both techniques during clinic practice should be as alternative as possible to practise the principle of radiation protection optimization recommended by International Atomic Energy Agency（IAEA）.