脊柱结核和非结核性脊柱炎的MRI影像鉴别

发布时间：2018-06-09 12:39

本文选题：脊柱感染 + 结核性脊柱炎　；参考：《临床放射学杂志》2015年06期

【摘要】：目的探讨脊柱结核与非结核性脊柱炎的MRI鉴别诊断价值。方法搜集2010年1月至2014年4月间我院脊柱感染性病变者53例,经手术、穿刺活检病理检查证实为结核33例及化脓性炎症18例,病原学检查证实为布鲁氏菌性脊柱炎2例,由两位有经验的影像诊断医师共同分析所有病例的MRI特征。结果 53例脊柱感染性病例中,累及多椎体52例,累及单椎体1例;共累及椎体139个,其中颈椎16个,胸椎44个,腰椎72个,骶椎7个;脊柱结核较其他感染性脊柱炎更易造成椎体塌陷畸形、椎间盘狭窄及破坏、死骨或钙化形成多,较易形成椎旁蔓延性脓肿及硬膜外脓肿蔓延;化脓性脊柱炎较易形成局限性椎旁脓肿或肉芽肿,均不超过椎体病变范围;布氏杆菌性脊柱炎有明显骨质增生,椎间盘受累不明显。结论根据观察MRI上病变椎体及其周围组织受累情况,结合临床,有助于脊柱结核与非结核性脊柱炎的鉴别。
[Abstract]:Objective to investigate the value of MRI in differential diagnosis of spinal tuberculosis and non tuberculous spondylitis. Methods 53 cases of spinal infection in our hospital from January 2010 to April 2014 were collected, and 33 cases of tuberculosis and 18 cases of suppurative inflammation confirmed by biopsy, and 2 cases of brucellosis spondylitis confirmed by pathogeny, with two experience. The MRI features of all cases were analyzed by the imaging diagnostics. Results in 53 cases of spinal infection, there were 52 cases involving multiple vertebral bodies, involving 1 cases of single vertebral body, involving 139 vertebral bodies, including 16 cervical vertebrae, 44 thoracic vertebrae, 72 lumbar vertebrae and 7 sacral vertebrae, and spinal tuberculosis was more likely to cause vertebral collapse and intervertebral disc stricture than other infectious spondylitis. Destruction, the formation of dead bone or calcification is more likely to form a paravertebral spread abscess and epidural abscess; suppurative spondylitis is more likely to form a localized paravertebral abscess or granuloma, both of which do not exceed the range of vertebral lesions; brucellosis spondylitis has obvious hyperosteogeny, and the intervertebral disc is not obvious. The involvement of surrounding tissues, combined with clinical practice, is helpful in differentiating spinal tuberculosis from non tuberculous spondylitis.
【作者单位】：广州中医药大学第一附属医院影像科;
【分类号】：R445.2;R681.51

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