多种影像学技术评价脊椎结核病理机制的初步研究

A preliminary study of CT and MRI evaluation on the pathological mechanism of lumbar vertebra tuberculosis

目的探讨兔腰椎结核动物模型的CT、MRI表现,为诊断腰椎结核提供影像学依据。方法健康新西兰白兔60只,通过腹部侧方入路手术方式将人型结核杆菌H37Rv标准菌株进行新西兰白兔腰椎种植,构建椎体结核动物模型,术后4、8w时行CT及MRI检查,并对病变行组织病理学检查。结果成功建立新西兰白兔腰椎结核动物模型。应用MRI常规检查方法及DWI检查可以早期发现椎体是否感染结核;且在术后第4、8周时MRI诊断脊柱结核不同病变的敏感性高于CT;病理学HE染色检查显示实验组病变椎体、椎旁软组织内可见脓细胞、类上皮样细胞及坏死组织。结论在新西兰白兔腰椎椎体进行结核标准菌株的种植感染,通过病理学检查证实可以构建出脊柱结核动物模型;CT、MRI能够为疾病早期诊断提供影像学依据,磁共振成像中弥散加权成像(DWI)序列更为敏感。

Objective To provide an animal model for basic research of bone tuberculosis.Methods Sixty healthy New Zealand rabbits were selected in this study.Firstly,animal models of spinal tuberculosis were made by operation,then they were examined with imaging and pathology methods at 4 weeks and 8 weeks respectively.Results The spinal tuberculosis model was successfully established in rabbits.Application of conventional MRI method and DWI method can be detected at an early stage bone which is infected with tuberculosis;and after 4 week,8 weeks,the sensitivity of MRI diagnosing spine tuberculosis is higher than that of CT.For the group with infections,pus,epithelioid cells or necrotic foci formation could be seen from vertebrae,paraspinal soft tissue sections according to the HE staining.Conclusion Rabbit spinal tuberculosis disease model can be successfully established though planting standard strains of human type Mycobacterium tuberculosis H37Rv on healthy rabbits lumbar.CT,MRI can provide early diagnosis of spinal tuberculosis with some information,DWI in MRI scanning method is more sensitive to early diag-nosis of spinal tuberculosis.