脊柱结核的MRI表现

MRI Characteristics of Spinal Tuberculosis

目的分析脊柱结核的MRI表现,提高该病的诊断水平。方法回顾性分析28例经手术病理证实的脊柱结核患者的MRI资料。结果(1)28例患者69个椎体受累,单椎体4例,2个椎体11例,3个椎体10例,4个椎体以上3例。T1WI呈均匀低信号31个,混杂低信号38个。T2WI及T2-TIR呈均匀高信号33个,混杂高信号36个。增强扫描呈不均匀强化。(2)21例32个椎间盘受累。T1WI呈低信号,T2WI及T2-TIR呈不均匀高信号。(3)椎旁寒性脓肿19例。T1WI呈稍低信号,T2WI及T2-TIR呈明显高信号,增强扫描称不均匀强化或环形强化。(4)6例8个椎弓根受累;6例脊髓受压。结论MRI多平面成像有利于观察脊柱、脊髓及周围软组织的病理形态学改变,综合分析有助于诊断及鉴别诊断。

Objective To analyze MR/features of spinal tuberculosis and improve the accuracy in diagnosing this disease. Methods MR/of 28 patients with spinal tuberculosis proved pathologically was analyzed retrospectively. Results （1） 69 vertebrates were involved in 28 patients. Only one vertebrates was involved in 4 of 38 ease,two vertebrates were involved in 11 ;three vertebrates were involved in 10;more than vertebrates 4 were involved in 3. On T1WI, hypointense was showed in 31 vertebrates, mixed hypointense in 38 vertebrates. On T2WI and T2 - TIR, 33 vertebrates showed hyperintense and 36 with mixed hyperintense; （2） 32 spinal discs had the pathological changes in 21 cases, T1WI showed low signal intensity,T2WI and T2 - TIR showed mixed high signal intensity; （3）19 patiens showed paravertebral ＂cold abscess＂. The abscess showed low signalintensity on T1WI, hyperintense on T2WI and T2 - TIR. Enhanced scanning showed irregular or circular enhancement; （4）6 patiens showed abnormal signal in 8 vertebal arches,Spinal cords were pressed in 6 patients. Condusion MRI can demonstrate the spinal vertebral and spinal cord and the paravertebral masses clearly by multiple planar neconstruction, these are helpful to the diagnosis and differential dignosis of the spinal tuberculosis.