椎间盘炎的MRI诊断(附10例报告)

MRI Diagnosis of Discitis

目的：总结椎间盘炎的ＭＲＩ表现。方法：复习１０例经病理和临床证实的ＭＲＩ表现，其中５例是血源性感染，５例是手术后或椎间盘穿刺术后椎间盘炎。９例的病变部位在腰椎，１例在颈椎。所有病人都进行了Ｇｄ－ＤＴＰＡ前后的Ｔ１ＷＩ和Ｔ２ＷＩ扫描。结果：ＭＲＩ表现包括：①椎间隙变窄，Ｔ２像呈高或低信号，Ｔ１像呈低或等信号。髓核内裂隙消失。②两个椎体的邻近部分由于充血和水肿而呈长Ｔ１长Ｔ２弛豫时间，终板侵蚀和终板下松质骨有小的脓肿。③椎旁软组织肿胀。④注射Ｇｄ－ＤＴＰＡ后椎间隙和邻近的椎体信号强度明显增强。结论：ＭＲＩ对椎间盘炎的诊断非常有用。

Purpose:To summarize the MRI features of the discitis .Methods:The MRI findings were reviewed in 10 cases with discitis proved by pathology and clinic,which of them five patients were hematogenous and other five were postopration or after disk puncture.The lesion sites of nine patients were lumbar disk and that of other one was cervical disk.All patients were performed pre and postGdDTPA administration T1WI as well as T2WI.Results:MRI findings include:①disk space narrowed,which showed high or low signal intensity on T2 imaging and low or isointensity on T1 imaging.The intranuclear cleft disappeared.②The adjacent portions of both vertebral bodies had long T1 and T2 relaxation times because of edema and congestion.Endplates were eroded and presented tiny abscess in the marrow under the endplates.③Paraspinal soft tissue swelling were observed.④The signal intensity in the disk spaces and adjacent vertebral bodies increased obviously after GdDTPA administration.Conclusion:MRI is a very useful procedure in diagnosing discitis and can demonstrate association abnormality such as arachnoiditis.