椎间盘介入术后椎间盘感染的CT及MRI征象研究

Study on the CT and MRI Findings of Intervertebral Infection After Intervertebral Intervention

目的：探讨椎间盘介入术后椎间盘感染的CT及MRI征象研究。材料与方法：对14例椎间盘介入术后椎间盘感染患者影像学资料、实验室检查、临床治疗等进行回顾性分析。结果：以手术病理为“金标准”，MRI诊断准确率为85．71％显著高于CT的35．71％（P〈0．05）。5例CT图像可见病灶部位低密度影向外膨出，椎体间脂肪间隙消失；12例MRI图像可见病灶及相邻椎盘1／3—1／2段T1WI低信号，T2WI高信号。经保守治疗和手术治疗后病情得到控制。结论：MRI诊断椎间盘介入术后椎间盘感染的准确性优于CT，对于保守治疗无效和严重感染可优先考虑微创手术治疗。

Purpose： To investigate the CT and MRI findings of intervertebral infection after intervertebral interven- tion. Materials and Methods： The imaging data, laboratory examination and clinical treatment of 14 patients with interverte- bral infection after intervertebral intervention were analyzed retrospectively. Results： With operation and pathology as the golden standard, the diagnostic accuracy of MRI （85.71%） was significantly higher than that of CT （35.71%） （P 〈0. 05）. CT images of 5 cases showed low-density shadow of lesions bulging outward and fat space in vertebral body disappeared; MRI images of 12 patients showed lesions and 1/3 - 1/2 segment of adjacent intervertebral disc low signal on T1WI and high sig- nal on T2WI. After conservative treatment and surgical treatment, the disease was controlled. Conclusion： The accuracy of MRI in the diagnosis of intervertebral infection after intervertebral intervention is better than that of CT. For patients who re- ceive conservative treatment and the treatment is ineffective and patients with serious infection, minimally invasive surgery can be firstly taken into consideration.