CT、MRI在脊柱结核中诊断价值的对比研究

The Contrast Study of CT and MRI in the Diagnosis of Spinal Tuberculosis

目的评价计算机断层成像(CT)、磁共振成像(MRI)在脊柱结核诊断中的临床价值。方法纳入手术病理及随访证实的30例脊柱结核患者的CT和MRI资料。20例先后行CT、MRI检查,1例仅行CT检查,9例仅行MRI检查。结果脊髓受压在MRI检查中有12例(41.4%,12/29),CT检查中有3例(13.6%,3/22),二者差异有统计学意义(P=0.031)。在先后行CT、MRI的患者中,椎管狭窄在MRI显示9例,在CT显示6例;脊髓受压在MRI显示7例,在CT上显示2例;椎间盘受累在MRI显示16例,CT显示13例;椎旁软组织脓肿MRI显示16例,CT显示13例。结论 CT较好的显示了脊柱结核的骨质破坏、附件受侵、椎间盘受累、椎旁软组织脓肿、椎管狭窄等病变,而MRI对显示脊髓受压有明显优势。二者相结合有助于脊柱结核的诊断。

Objective To evaluate the clinical value of computed tomography （CT）, magnetic resonance imaging （MRI） in the diagnosis of spinal tuberculosis. Methods Thirty cases of spinal tuberculosis that were confirmed by histopathology in surgery and follow-up. Twenty patients were examined with both CT and MRI, only one by CT scan, 9 cases by MRI. The information about CT, MRI and clinical data were collected. Results MRI and CT showed the spinal cord compression prospectively were 41.4%（12/29） and 13.6% （3/22）, there was statistical difference （P=0.031）. For patients with both MRI and CT examination, the spinal stenosis was found in 9 cases by MRI, 6 cases by CT; the spinal cord compression was found in 7 cases by MRI, 2 cases by CT; the affected intervertebral disc was found in 16 cases by MRI, 13 cases by CT. The paraspinal soft tissue abscesses was found in 16 cases by MRI, 13 cases by CT. Conclusion Spinal tuberculosis bone destruction, accessories invasion, disc involvement, paraspinal soft tissue abscess, and spinal stenosis could be better showed by CT. However, MRI has obvious advantages for detecting spinal cord compression. Combination of both MRI and CT could contribute to the diagnosis of spinal tuberculosis.