脊柱结核的CT表现及诊断价值

CT Imaging and Diagnosis of Vertebral Tuberculosis

目的 :分析脊柱结核的CT表现 ,提高CT对诊断脊柱结核重要性的认识。材料与方法 :对 5 1例脊柱结核进行CT扫描 ,13例做了静脉增强 ,5例做了CTM扫描 ,均有常规脊柱正侧位片。均经穿刺活检和 /或手术病理证实 ,其中穿刺活检11例 ,手术证实 4 0例。结果 :病变部位分布 :胸椎 18例 ,腰椎 2 5例 ,骶椎 3例 ,胸腰段 3例 ,腰骶段 2例。其CT表现为骨质破坏、骨质增生硬化、死骨及新生骨形成、椎间盘的溶解破坏或退变、椎旁软组织肿胀 /肿块和腰大肌脓肿、骨性椎管狭窄。结论 :应用CT扫描不仅能显示脊柱结核的形态特征 ,而且能发现早期骨质破坏。

Purpose:To analyze CT imaging of vertebral tuberculosis and improve the value of the CT imaging to vertebral tuberculosis.Materials and Methods:51 case had been carried through CT scan,13 cases had vein contrast,5 cases had CTM scan.All cases have routine X-ray film of spine from lateral view and P-A view.11 cases have been carried through puncture biopsy,and 40 case have been confirmed by operate.Results:Lesion place:18 cases in thorax vertebra,25 cases in lumbar,3 case in sacrum,3 cases in lumbothorax vertebra,2 cases in sacolumbar vertebra.CT imaging shows bone destruction and hyperplasia,sequestra neonataosseous,destruction and degeneration of inter vertebral disc,parenchyma swell or bump of paravertebra and abscess of big lumbar muscle,stenosis of bone vertebral tube.Conclusion:CT imaging not only display the shape of vertebral tuberculosis,but also find early bone destruction.CT imaging has greatvalue in the treatment and prognosis of vertebral tuberculosis.