脊柱结核磁共振成像增强扫描的意义

The significance of MRI enhanced scan in the spinal tuberculosis

目的通过分析脊柱结核的磁共振成像(magnetic resonance imaging,MRI)影像表现,提高对脊柱结核的诊断、认识。材料与方法回顾性分析经活检和手术病理检查证实的57例脊柱结核患者的MRI影像资料,分析脊柱结核MRI平扫及增强扫描影像表现。结果 57例患者中颈椎结核5例、胸椎结核12例、腰椎结核24例,颈椎合并胸椎3例,胸椎合并腰椎8例,腰椎合并骶椎5例。单椎体受累2例,相邻2个椎体受累41例,3个及3个以上椎体受累14例。43例椎间隙狭窄或消失,40例脓肿形成。增强扫描41例病灶区域明显强化,16例弱强化或无强化。57例患者均接受1~3月不等强化多联抗结核化疗治疗。15例患者术前多次行MR增强扫描检查,12例患者影像学表现不同程度好转,3例无明显变化。结论 MRI增强扫描对早期诊断脊柱结核及指导临床治疗有着重要的应用价值。

Objective:To improve the diagnosis of spinal tuberculosis by analyzingthe MRI imaging findings of spinal tuberculosis.Materials and Methods:MRIimaging data of57patients with spinal tuberculosis confirmed by biopsy and surgeryand pathology were analyzed retrospectively.The findings of MRI plain scan andenhanced scan images of spinal tuberculosis were analyzed.Results:Fifty-sevencases of cervical tuberculosis in5cases,12cases of thoracic tuberculosis,24cases oflumbar spine tuberculosis.Cervical vertebrae complicating thoracic vertebrae were3cases.Thoracic vertebrae complicating lumbar were8cases.Lumbar complicatingsacral vertebrae were5cases.Only one vertebrae was involved in2cases,twovertebraes were involved in41cases,more than three vertebraes were involved in14cases.There were stenosis or disappearance of intervertebral space in43casesand40cases had cold abscess.There were obviously enhanced in41cases and weakor no enhanced in16cases by MR enhanced scan.57patients were treated with1-3months by the combination of multiple anti-tuberculosis chemotherapy.MR scan wasperformed more than2times in15patients before operation.12patients'imagingperformances were better than that of anti-tuberculosis chemotherapy and3cases werenot.Conclusion:MRI enhanced scan has important application value in diagnosis andtreatment of spinal tuberculosis.