早期脊椎结核的MRI表现分析

MRI features of spinal tuberculosis at the early stage

目的 :探讨早期脊椎结核的MRI表现 ,评价MRI反映早期脊椎结核病理特征的能力。方法 :回顾 1 1例经穿刺活检、临床抗结核治疗证实的早期脊椎结核的的MRI表现 ,结合X线等资料分析。结果 :共 2 6个病椎 ,其中 5个“虫蚀状”骨质破坏 ,2 6个椎体骨炎 ;1 1例椎体周围软组织肿胀 ,并椎旁、椎前脓肿 4例 ;T2WI病椎椎间盘临近破坏终板裂隙状高信号 5个 ,Gd DTPA增强表现为裂隙状强化 ;病椎后硬膜外脓肿 7例 ,Gd DTPA增强后脓肿壁、后纵韧带线样强化。结论 :椎体骨炎、病椎虫蚀状骨质破坏、多个椎体周围软组织肿胀、T2WI椎间盘临近破坏终板裂隙状高信号、病椎后硬膜外脓肿、Gd DTPA增强检查椎间盘裂隙状强化、后纵韧带强化等是早期脊椎结核富有特征性的MRI表现 。

Objective:To consider the MRI features of spinal tuberculosis at the early stage(STES) and evaluate the ability that MRI reflects pathology of STES Methods: To combine with their spinal radiography, the MRI features of 11 cases with STES proven by biopsy or confirmed by clinically antituberculous therapy were reviewed and carefully analyzed Results: 5'worm eaten' destructive vertebral bodies in 26 involved vertebral bodies and 26 vertedral bodies with osteitis, there were pre and paraspinal soft tissue inflammatory edema in 11 cases, and fissural hyperintense signals in 5 intervertebral discs adjacent to destructive end plates on T 2 weighted images and being enhanced after Gd DTPA enhancement scanning, there were small epidural abscesses at the posterior margins of the invloved vertebral bodies in 7 cases and the vertebral bodies, walls of abscesses and posterior longitudinal ligaments were enhanced after Gd DTPA enhancement scanning Conclusion: The MRI features of osteitis,'worm eaten' destruction of the vertebral bodies, inflammatory edema of pre and paraspinal soft tissues, fissural hyperintense signals of intervertebral discs adjacent to destructive end plates on T 2 weighted images, postspinal epidural abscesses and enhanced patterns of the involved vertebra and intervertebral discs, abscesses and the posterior longitudinal ligaments after Gd DTPA enhancement scanning were very specific, and the MRI examination can well demonstrate pathological changes of STES,