脊椎结核的MRI诊断价值与脊椎转移瘤对照研究

Study of tuberculosis and metastasis tumors of spine with MRI

目的探讨ＭＲＩ对脊椎结核的诊断价值。材料与方法对１３例脊椎结核行矢状位Ｔ１ＷＩ、Ｔ２ＷＩ、ＤＷＩ、ＦＡＳＴ准Ｔ２ＷＩ及轴位Ｔ１ＷＩ成像；７例行Ｇｄ－ＤＴＰＡ增强。随机抽取３０例脊椎转移瘤作对照组。观察两组病变椎体、终板、椎间盘和周围软组织的信号变化和增强后改变。结果（１）ＭＲＩ对鉴别椎体骨炎和转移瘤性椎体骨浸润价值较大；（２）骨内与椎旁冷脓肿形成及椎间盘改变是脊柱结核的典型ＭＲＩ表现；（３）Ｇｄ－ＤＩＰＡ增强可清楚显示冷脓肿周围纤维肉芽组织及椎管内侵犯；（４）终板破坏常见于脊椎结核。结论ＭＲＩ对脊椎结核与脊椎转移瘤有较大鉴别诊断价值，对早期和不典型脊椎结核的诊断亦有较大价值。

Purposes To investigate the diagnosing value of tuberculosis of the spine in MRI.Materials and methods 13 cases of tuberculosis of the spine were examined with T1,WImT2WI,dwi,et al.Gd-DTPA contrast was used in 7cases with sagittal and axial T1- weighted image.30 cases of spinal metastases were picked up at random to server as reference group .The signals at every sequence and series about the vertebra, end-plates, intervertebral discs and the soft tissue around it were observed. Results 1)MRI has great value in distinguish- ing osteitis with spinal metastases.2)abscess in and by vertebra side and the intervertedbral discs distructed were the typical MRI features of spi- nal tuberculosis.3)With Gd-DTPA contrast ,fibrogranulation around abscess and destruction area was shown clearly.4)destruction of the end plate were common in tuberculosis of the spine.Conclusion MRI had much value in distinguishing tuberculosis of the spine with spinal metas- tases.It has great value also in diagnosing atypical spinal tuberculosis at its early stage.