早期和非典型脊柱结核中MRI的诊断分析

Diagnostic analysis of MRI in early and atypical spinal tuberculosis

目的分析早期和非典型脊柱结核中MRI的诊断价值。方法筛选脊柱结核患者200例作为研究对象,对其临床资料进行回顾性分析,所有患者均行X线、CT及MRI检查,对比分析3种检查的诊断结果,综合评价MRI在早期和非典型脊柱结核诊断中的应用价值。结果X线、CT、MRI检查对脊柱结核诊断的符合率分别为36.5%(127/200)、77.5%(155/200)、97.0%(194/200),MRI检查高于CT检查和X线检查,CT检查高于X线检查,差异有统计学意义(χ^2=69.062,P=0.001)。CT检查对于死骨形成诊断的敏感度(95.69%;200/209)明显优于X线(34.93%;73/209)和MRI(30.63%;64/209);MRI检查对受累椎体、椎间盘、椎管诊断的敏感度分别为100%(512/512)、100%(354/354)和95.71%(201/210),均优于X线的57.23%(293/512)、46.32%(164/354)、30.47%(64/210)和CT的73.24%(375/512)、74.29%(263/354)、56.67%(119/210),差异有统计学意义(χ^2=67.961,P<0.001)。结论早期和非典型脊柱结核MRI检查的诊断价值较高,可清晰显示脊柱结核的不同征象,具有较高的敏感性,值得推广。

Objective To analyze the diagnostic value of MRI in early and atypical spinal tuberculosis.Methods The clinical data of 200 patients with spinal tuberculosis diagnosed were analyzed retrospectively.All patients were examined by X-ray,CT and MRI.The diagnostic results of the three methods were compared and analyzed,and the value of MRI in the diagnosis of early and atypical spinal tuberculosis was comprehensively evaluated.Results The coincidence rates of X-ray,CT and MRI in the diagnosis of spinal tuberculosis were 36.5%(127/200),77.5%(155/200)and 97.0%(194/200),MRI was higher than CT and X-ray,and CT was higher than X-ray,the difference was statistically significant(χ^2=69.062,P=0.001).The sensitivity of CT examination in the diagnosis of dead bone formation(95.69%;200/209)was much better than that of X-ray(34.93%;73/209)and MRI(30.63%;64/209).The sensitivity of MRI in the diagnosis of involved vertebral body,intervertebral disc and spinal canal was 100%(512/512),100%(354/354)and 95.71%(201/210),respectively,which was better than that of 57.23%(293/512),46.32%(164/354)、30.47%(64/210)of X-ray,and 73.24%(375/512),74.29%(263/354)and 56.67%(119/210)of CT.The difference was statistically significant(χ^2=67.961,P<0.001).Conclusion MRI is valuable in the diagnosis of early and atypical spinal tuberculosis,it can clearly show the different signs of spinal tuberculosis and has high sensitivity,which is worth popularizing.