脊柱结核的MRI表现

MRIfeaturesoftuberculosisofthespine

目的：探讨脊柱结核的ＭＲＩ表现，并和脊柱转移瘤鉴别。材料和方法：选择２０例经手术证实的脊柱结核和１０例临床证实的脊柱转移瘤，分别观察椎体、椎间盘、附件破坏的情况，脓肿的有无，ＭＲ信号的变化，硬膜囊和脊髓受压的位置和原因。结果：脊柱结核椎间盘均破坏变窄，椎体破坏位置多靠近椎间盘，只有３例附件破坏。破坏椎间盘和椎体周围的２０例均有脓肿，脓肿为从前方压迫硬膜囊和脊髓的主要原因，少数为楔状变形的椎体。１０例脊柱转移瘤椎间盘均未受累，ＭＲ信号正常，９例附件破坏，压迫硬膜囊和脊髓的原因为变形的椎体和硬膜囊后方的硬膜外转移。结论：脊柱结核和脊柱转移瘤均有自己的特征性ＭＲＩ表现，注意观察受累椎体形态、椎间盘和附件是否受累、脓肿的有无和对硬膜囊及脊髓压迫的情况，有助于诊断和鉴别。

Purpose:ToinvestigatetheMRIfeaturesoftuberculosisofspineanddiferentialdi-agnosisfrombonemetastasis.Materialsandmethods:20casesofsurgicalyproventuberculosisofspineand10clinicalyconfirmedcasesofmetastasisofspinewereselectedforcomparison.TheMRIfeaturesofbonydestruction,abscessformation,changesofMRsignalintensityandcompresionofthethecalsacandspinalcordwereevaluated.Results:Intuberculosisofspine,theintervertebraldiscsweredestroyedandnarowed,destructionofthevertebralbodyoccuredadjacenttothedisc,only3casesshoweddestructionoftheaccessoryparts.Abscessformationwasseeninalcaseswherethereweredestructionofvertebralbodyandintervertebraldisc.Abscessformationwasthemaincauseofcompressionofthethecalsacandcordanteriorly.Afewvertebralbodiesbecamewedge-shaped.Therewasnoinvolvementoftheintervertebraldiscinmetastasisofspine.MRIsignalofthediscwasnormal.Theaccessorypartsweredestroyedin9cases.Thecauseofcompressionofthecalsacandcordwasthedeformedvertebralbodyandextraduralmetastaticlesion.Conclusion:Tubercu-losisandmetastasisofspinedemonstratedtheirspecialMRIfeatures.Carefulobservationoftheshapeofthevertebralbodyinvolved,anyinvolvementofthediscandaccessoryparts,presenceofab-scessformationandconditionofcompressionofthecalsacandcordwashelpfulindiferentialdiagno-sisbetweenthesetwoconditions.