化脓性脊椎炎与结核性脊椎炎的MRI鉴别

Differentiation of pyogenic spondylitis and tuberculous spondylitisby on magnetic resonance images

目的:提高化脓性脊椎炎(PS)与结核性脊椎炎(TBS)的MRI鉴别诊断水平。方法:收集经手术/局部病灶穿刺活检病理证实或临床随访证实的20例化脓性脊椎炎和30例结核性脊椎炎,比较其MRI表现,用χ2检验进行统计学分析。结果:以下MRI表现PS与TBS之间具有显著性差异(P<0.05):胸椎受累(PS为14.3%,TBS为56.9%);腰椎受累(68.6%,33.8%);病变椎体破坏变形(0,56.7%);椎旁软组织受累(30%,70%);椎旁脓肿形成(0,70%);韧带下蔓延(20%,63.3%);T2WI高信号(35%,70%)。结论:MRI检查能够为PS与TBS的鉴别提供可靠信息。

Objective：To assess magnetic resonance imaging features in differentiating pyogenic spondylitis （PS） from tuberculous spondylitis （TBS）. Methods： Compared MRI findings of pyogenic spondylitis（ 20 patients） with tuberculous spondylitis（30 patients）. Statistical analysis was performed with the chi-square test. Results： The incidence of the following MRI findings had a significant difference in patients with pyogenic spondylitis than in those with tuberculous spondylitis （ P〈 0.05）; thoracic spine involvement （14.3% in pyogenic vs 56.9% in tuberculous） ; lumbar involvement （68.6% vs 33.8% ）;destructive lesions of the vertebral body and vertebral collapse（0 vs 56.7%）; abnormal paravertebral soft tissue （30% vs 70%） ;presence of paraspinal abscess （0 vs70%） ;subligamentous spread （20 % vs 63.3%）and Hyperintense signal on T2-weighted images （35% vs 70%）. Conclusion： Magnetic resonance imaging are helpful for differentiation of pyogenic spondylitis from tuberculous spondylitis.