脊柱结核骨代谢相关指标水平变化及影像学诊断分析

Changes of Bone Metabolism Related Indexes and Imaging Diagnosis of Spinal Tuberculosis

目的分析脊柱结核骨代谢指标情况,并比较CT、MRI对脊柱结核的诊断价值。方法选取本院2014年1月-2016年1月就诊的47例脊柱结核患者为观察组研究对象,均行CT、MRI检查,观察比较CT、MRI对脊柱结核椎体破坏、椎间盘受累、椎管狭窄等征象的显示率。另外选择同期健康体检50例正常人群为对照组,测定两组骨钙素(BGP)等骨代谢指标。结果 CT对脊髓受压显示率12.77%,MRI对脊髓受压显示率40.43%,两者比较差异有统计学意义(P<0.05),而两者在椎管狭窄、椎旁软组织脓肿等征象显示上无显著差异(P>0.05)。观察组与对照组血清碱性磷酸酶(ALP)、I型胶原C端肽(CTX-I)水平比较差异有统计学意义(P<0.05)。结论 CT、MRI对脊柱结核椎间盘受累、椎管狭窄等病变征象均能良好显示,但MRI在脊髓受压显示上比CT显著高。血清ALP、CTX-I对脊柱结核判断有一定的辅助作用。

Objective To analyze the bone metabolism related indexes of spinal tuberculosis, and to compare the value of CT and MRI in the diagnosis of spinal tuberculosis.Methods Forty-seven cases of patients with spinal tuberculosis who were treated in our hospital between January 2014 and January 2016 were enrolled in the observation group. All patients underwent CT and MRI examination. The display rates of CT and MRI in spinal tuberculosis with destroyed vertebral body, disc involvement and spinal canal stenosis were observed and compared. Another 50 cases of normal people who underwent health examination in the same period were selected as control group. Bone gla protein （BGP） and other bone metabolism indexes in the two groups were determined.Results The display rate of CT for spinal cord compression was 12.77% while MRI was 40.43% （P〈0.05）. There was no significant difference in displaying spinal stenosis and paravertebral soft tissue abscess between the two methods （P〉0.05）. The differences in levels of serum alkaline phosphatase （ALP）, type I collagen C terminal peptide （CTX-I） levels between the two groups were significant（P〈0.05）.Conclusion Both of CT and MRI can well display intervertebral disc involvement of spinal tuberculosis, spinal stenosis and other signs. However, the display rate of MRI in spinal cord compression is significantly higher than that of CT. The levels of serum ALP and CTX-I have an auxiliary effect on the diagnosis of spinal tuberculosis.