脊柱结核的CT诊断

The CT findings of spinal tuberculosis

目的探讨脊柱结核的CT诊断及鉴别诊断。方法对43例脊柱结核进行回顾性分析。其中男24例,女19例。年龄10～57岁。15例经手术病理证实,18例经穿刺活检证实,10例经抗结核治疗痊愈证实。结果脊柱结核的CT表现为:①斑片、斑点状、洞穴状或蜂窝状骨质破坏(43/43例);②椎体骨质密度增高(13/43例);③椎间盘破坏(32/43例);④死骨形成(30/43例);⑤椎旁脓肿,其内常有钙化灶(38/43例);⑥骨性椎管狭窄(8/43例);⑦椎体压缩改变(28/43例)。结论CT对脊柱结核的诊断与鉴别诊断具有重要价值。

Objective To investigate the CT diagnosis and differential diagnosis of spinal tuberculosis.Methods CT manifestations were retrospectively analyzed in 43 cases of spinal tuberculosis.This series included 24 males and 19 females,aged 10-57 years.15 cases were confirmed by operation and pathology;18 cases were confirmed by biopsy and 10 cases were cured by antituberculostic therapy.Results The CT manifestations of spinal tuberculosis were: 1mottling, patchy, caved or faveolate bone destructions (43/43 cases);2elevated density of the involved vertebrae(13/43 cases);3destruction of intervertebral discs(32/43 cases);4formation of sequester (30/43cases);5para-vertebral abscess,often with calcification(38/43 cases);6osseous vertebral canal narrowing(8/43 cases);7vertebrae compression(28/43 cases).Conclusion CT scan is a valuable modality for the diagnosis and differential diagnosis of spinal tuberculosis.