脊柱结核病灶MSCT、MRI表现及其诊断价值研究

Manifestations and Diagnostic Value of MSCT and MRI in Spinal Tuberculosis Patients

目的探讨脊柱结核病灶的多层螺旋CT(MSCT)、磁共振(MRI)表现及其诊断价值。方法收集2016年1月~2019年1月我院收治、经手术病诊断的54例脊柱结核患者手术资料、影像学资料。比较MSCT与MRI诊断脊柱结核准确性、阳性征象(骨质破坏、骨质钙化、坏死、椎管狭窄、椎旁脓肿、脊髓侵犯)检出率、病灶检出时间、检出总时间等指标差异性。结果MSCT诊断脊柱结核阳性48例,诊断率88.89%,MRI诊断脊柱结核阳性50例,诊断率92.59%,两者比较差异无统计学意义(P>0.05);MSCT对骨质钙化、坏死的检出率高于MRI(P<0.05),MRI对脊髓侵犯的检出率高于MSCT(P<0.05),两种检查方式对骨质破坏、椎管狭窄、椎旁脓肿的检出率比较差异无统计学意义(P>0.05);MSCT的病灶检出时间、检查总时间均较MRI短(P<0.05)。结论MSCT和MRI对脊柱结核有较高的诊断价值且各具优势,MSCT诊断骨质坏死、钙化更为灵敏,MRI诊断脊髓侵犯准确性更高,MSCT检查时间短适用于疾病的初次筛查。

Objective To investigate the manifestations and diagnostic value of multislice spiral CT(MSCT)and nuclear magnetic resonance imaging(MRI)in spinal tuberculosis patients.Methods Surgical data and imaging data of 54 patients with spinal tuberculosis admitted to our hospital from January 2016 to January 2019 and diagnosed by surgical diseases were collected.The accuracy of MSCT and MRI in diagnosing spinal tuberculosis,the differences in the detection rate of positive signs(bone destruction,calcification,necrosis,spinal stenosis,paraspinal abscess,spinal cord invasion),the detection time of lesions,and the total detection time were compared.Results There were 48 cases of spinal tuberculosis diagnosed by MSCT with the diagnostic rate of 88.89%.And 50 cases of spinal tuberculosis were diagnosed by MRI with the diagnostic rate of 92.59%.There was no significant difference between the two groups(P>0.05).The detection rate of bone calcification and necrosis in MSCT was higher than that in MRI(P<0.05),MRI,and the detection rate of spinal cord invasion was higher than that in MSCT(P<0.05).The two methods had higher detection rate of bone destruction and spinal canal stenosis.There was no significant difference in the detection rate of paravertebrate abscess(P>0.05).The detection time and total time of MSCT were shorter than those of MRI(P<0.05).Conclusion Both of MSCT and MRI have high diagnostic value and advantages for spinal tuberculosis.MSCT is more sensitive for the diagnosis of osteonecrosis and calcification,MRI is more accurate for the diagnosis of spinal cord invasion,and the MSCT examination time is short and suitable for the initial screening of diseases.