脊柱结核病灶MSCT、MRI影像学表现及对内镜手术指导价值分析

MSCT and MRI Imaging Features of Spinal Tuberculosis and Its Guiding Value for Endoscopic Surgery

目的研究脊柱结核病灶MSCT、MRI影像学表现及对内镜手术指导价值。方法回顾分析本院2017年6月至2019年6月收治的70例脊柱结核患者的临床资料,所有患者均接受MSCT、MRI检查。观察患者影像学表现,记录并比较MSCT检查、MRI检查所需总时间、病灶检出时间以及对脊柱结核阳性征象(脊髓侵犯,骨质钙化、坏死,椎管狭窄、椎旁脓肿以及骨质破坏等情况)检出率。结果MSCT检查所需总时间、病灶检出时间均短于MRI检查(P<0.05);MSCT、MRI检查在椎管狭窄、椎旁脓肿、骨质破坏检出率比较差异无统计学意义(P>0.05),在脊髓侵犯、骨质钙化、坏死检查中差异有统计学意义(P<0.05)。脊柱结核MSCT影像学表现为骨质坏死、椎旁脓肿、死骨形成、椎间盘破坏、骨质增生硬化等;MRI检在细菌浸润阶段可发现异常信号。结论MSCT、MRI在检查脊柱结核上各有优势,通过对两种检查所得图像进行分析,对患者内镜手术治疗有较高指导价值。

Objective To study the MSCT and MRI imaging features of spinal tuberculosis and its guiding value for endoscopic surgery.Methods The clinical data of 70 patients with spinal tuberculosis admitted to our hospital from June 2017 to June 2019 were retrospectively analyzed.All patients underwent MSCT and MRI.The patient's imaging findings were observed.The total time required for MSCT examination,MRI examination,the detection time of lesion were recorded,and the detection rates of positive signs of spinal tuberculosis(spinal cord invasion,sclerotin calcification,necrosis,spinal stenosis,paraspinal abscess and sclerotin destruction)were compared.Results The total time required for MSCT examination and the time of detection of lesions were shorter than those of MRI(P<0.05).There was no significant difference in the detection rate of spinal canal stenosis,paraspinal abscess and sclerotin destruction between MSCT and MRI(P>0.05),the difference was statistically significant in spinal cord invasion,sclerotin calcification and necrosis(P<0.05).The MSCT imaging findings of spinal tuberculosis include osteonecrosis,paraspinal abscess,sequestration,disc destruction,and hyperostosis and osteosclerosis.MRI examination can show abnormal signals during the tage of bacterial infiltration.Conclusion MSCT and MRI have their own advantages in the examination of spinal tuberculosis.By analyzing the images obtained by the two examinations,it has a high guiding value for endoscopic surgery.