磁共振成像对腰椎间盘突出症术后椎间隙感染的早期诊断评价

Evaluation of magnetic resonance imaging(MRI)for the early diagnosis of postoperative intervertebral space infection of lumbar disc herniation

目的对腰椎间盘突出症术后椎间隙感染患者行磁共振成像(MRI)扫描检查,探讨其在疾病早期诊断中的价值,旨在为临床治疗提供依据。方法选取2011年1月-2014年6月收治的腰椎间盘突出症术后椎间隙感染患者21例,采用磁共振成像仪对患者进行MRI检查,并在确诊后采取及时有效的方法进行治疗,并对患者进行2年随访,分析MRI诊断特点,观察患者治疗效果,并对患者治疗前后白细胞、C-反应蛋白及血沉等变化进行比较。结果经MRI扫描检查后,所有患者椎间隙感染部位均为L4-5或L5-S1腰椎间隙,其感染发生部位基本与腰椎间盘突出病变发生部位相一致;21例患者中单发感染患者16例占76.2%,多发感染5例占23.8%;所有患者MRI扫描信号均呈现T1低信号,且均较为对称,T2高信号,其扫描征象主要表现为椎间盘破裂及椎体终板分离;经2年随访,其中临床症状完全消失的患者有19例占90.5%;与治疗前比较,所有患者治疗后白细胞、C-反应蛋白及血沉水平均显著降低,且恢复至正常水平,差异有统计学意义(P<0.05)。结论腰椎间盘突出症术后椎间隙感染患者经MRI检查均能够对病变情况进行充分显示,对感染早期临床诊断与鉴别具有较高的应用价值。

OBJECTIVE Magnetic resonance imaging（MRI）scans were performed in patients with postoperative intervertebral space infection of lumbar disc herniation,in order to explore its value in the early diagnosis of the disease,so as to provide the basis for clinical treatment.METHODS A total of 21 cases of patients with postoperative intervertebral space infection of lumbar disc herniation from Jan.2011 to Jun.2014 were selected.MRI was used in all patients,and prompt and effective methods were taken for treatment after diagnosis.The patients were followed up for 2years to analyze the characteristics of MRI diagnosis and to observe the therapeutic effect.The differences of white blood cells,C-reactive protein and blood sedimentation rate before and after the treatment were compared.RESULTS After an MRI scan,all patients with intervertebral space infection sites were L4-5or L5-S1 lumbar intervertebral space,the sites of infection and lumbar disc disease sites were basically the same place.In 21 patients,16patients were single infection（76.2%）,and 5cases were multiple infection（23.8%）.There were low signal intensity of T1 scan in all patients,and they were symmetrical,and were high signal intensity of T2,the main signs of which were disc rupture and vertebral endplate separation.After 2years of followup,the clinical symptoms disappeared in 19 patients,accounted for 90.5%,compared with the situation before treatment,white blood cells,C-reactive protein and blood sedimentation of all patients after treatment were significantly lower,and the difference was statistically significant（P〈0.05）.CONCLUSIONLumbar disc herniation in patients with intervertebral space infection by MRI examination of lesions can be fully displayed,and it is of high value in clinical diagnosis and differential diagnosis of early infection.