脊柱结核影像学特点临床分析

摘要

Objective To summarize imaging characteristics of spinal tuberculosis.Methods Clinical data of 38 patients with spinal tuberculosis confirmed by postoperatively pathological results during February 2010 and June 2013 was retrospectively analyzed.Results All patients underwent CT and MRI examinations.There were 16 patients with vertebral collapse, 12 patients with visible sequestrum and 10 patients with 2 or more adjacent vertebral destruction.There were 32 patients with narrow intervertebral space, 4 patients with intervertebral disc disappearance and 2 patients with no obvious changes of intervertebral disc.There were 4 patients with involvement of vertebral arch, 1 patient with involvement of vertebral plate and 33 patients with no abnormalities of adnexa.There were 35 patients with different degrees of paraspinal soft tissue shadows and 3 patients without the shadows.There were 12 patients with soft tissue bursting into the spinal canal, 5 patients with involvement of spinal cord and dura mater, and 21 patients with compression, deformation and displacement in spinal cord and dura mater capsule.The result by CT diagnosis was 34 patients with spinal tuberculosis, and the diagnosis coincidence rate was 89.47％, while the result by MRI was 35 patients with spinal tuberculosis, and the diagnosis coincidence rate was 92.11％, but the difference was not statistically significant (P > 0.05).Conclusion The CT and MRI characteristics of spinal tuberculosis are special, and therefore it can provide references for confirming diagnosis and giving the therapeutic plan.%目的 总结脊柱结核的影像学特点.方法 对2010年2月-2013年6月我院收治的经手术病理确诊为脊柱结核的38例临床资料进行回顾性分析.结果 所有患者均行CT及MRI检查,出现椎体塌陷16例,可见死骨12例,有2个以上相邻椎体破坏10例;出现椎间隙狭窄32例,椎间盘消失4例,椎间盘未见明显变化2例;累及椎弓4例,累及椎板1例,附件未见异常33例;出现不同程度椎旁软组织影35例,未见椎旁软组织影3例;软组织突入椎管内12例,脊髓及硬膜受累5例,脊髓及硬膜囊受压、变形及移位21例.CT诊断脊柱结核34例,确诊率89.47％,而MRI诊断脊柱结核35例,确诊率92.11％,比较差异无统计学意义(P>0.05).结论 脊柱结核CT及MRI影像学特点具有特异性,可为临床确诊及制定治疗方案提供参考依据.