脊柱结核的MRI诊断价值

Value of MRI in the diagnosis of spinal tuberculosis

目的分析脊柱结核的MRI表现,探讨MRI的诊断价值。方法回顾性分析2005年6月～2007年2月在我院行MRI检查,并经手术病理或临床治疗随访证实的脊柱结核20例,观察椎体、椎间盘、椎旁脓肿及椎管等变化。结果20例脊柱结核,共42个椎体受累,13例椎体变形,椎间盘破坏、消失15例,18例见椎旁脓肿影,硬膜囊及脊髓受压13例,2例于T2WI可见脊髓异常高信号。结论MRI对脊柱结核病理改变具有高敏感性,脊柱结核的MRI影像学表现能早期明确脊柱结核椎体的破坏、椎间盘信号的改变以及椎旁脓肿范围,同时能早期明确硬膜囊受压情况和脊髓受累范围,对临床早期诊断和指导治疗有重要意义。

Objective To analysis the appearance of MRI for 20 patients with spinal tuberculosis, and to evaluate the value of MRI in spinal tuberculosis. Methods The MRI features of 20 patients who were performed MRI from June 2005 to June 2007 with spinal tuberculosis and proved by operational biopsy and clinical follow-up were reviewed. The MRI changes of vertebrae,intervertebral discs, abscess and vertebral canal were observed. Results The images of MRI in 20 cases of spinal tuberculosis suggested that there were a total of 42 vertebrae involvement, 13 vertebral deformation ,the destruction of 15 intervertebral disc, and 18 paraspinal abscess can be defined. There were dural sac and spinal cord compression in 13 cases,high signal spinal cord abnormalities in the T2-weighted of two cases. Conclusion MRI has the high sensitivity to the tuberculosis pathology change. MRI performance of Spinal tuberculosis can early show the destruction of vertebrae, the signal changes of intervertebral disc and the scope of the paraspinal abscess. Meanwhile, it can show the early compression of dural sac and the scope of spinal cord involved. It is helpful for early clinical diagnosis and treatment.