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目的探讨脊柱结核的MRI表现特征。方法回顾性分析38例经手术病理证实的脊柱结核患者的MRI资料。结果(1)38例患者101个椎体受累,单椎体5例,2个椎体13例,3个椎体12例,4个椎体以上8例。T1WI呈均匀低信号37个,混杂低信号61个,等信号3个。T2WI及T2/SPIR呈均匀高信号34个,混杂高信号63个,等信号4个。增强扫描呈不均匀强化。(2)29例45个椎间盘受累,椎间隙狭窄27个,椎间隙消失18个。T1WI呈低信号,T2WI及T2/SPIR呈不均匀高信号。(3)27例寒性脓肿形成,其中25例为椎体前缘或周围脓肿,5例伴腰大肌脓肿,14例见椎管内脓肿。脓肿T1WI呈稍低信号,T2WI及T2/SPIR呈明显高信号,增强扫描呈不均匀强化或环形强化。(4)12例患者19个椎弓根受累;19例脊髓受压。结论脊柱结核病变具有多样性,病变可累及椎体的各部位,MRIT1WI及T2WI以混杂信号为主,综合分析有助于诊断和鉴别诊断。
Objective To investigate the MRI features of spinal tuberculosis. Methods The MRI data of 38 patients with spinal tuberculosis confirmed by surgery and pathology were retrospectively analyzed. Results (1) 38 vertebral bodies were involved in 101 cases, including 5 cases of single vertebra, 13 cases of 2 vertebrae, 12 cases of 3 vertebral bodies and 8 cases of 4 vertebral bodies. T1WI showed uniform low signal 37, mixed low signal 61, such as the signal 3. T2WI and T2 / SPIR showed a uniform high signal 34, mixed high signal 63, the other four signals. Enhanced scan showed uneven enhancement. (2) Twenty-nine cases of 45 discs involved 27 intervertebral space stenoses and 18 intervertebral spaces disappeared. T1WI showed low signal, T2WI and T2 / SPIR showed uneven high signal. (3) 27 cases of cold abscess formation, of which 25 cases of anterior or peripheral vertebral abscess, 5 cases of psoas muscle abscess, 14 cases of intraspinal abscess. T1WI abscess was slightly lower signal, T2WI and T2 / SPIR was significantly higher signal enhancement scan was uneven enhancement or annular enhancement. (4) Nineteen pedicle screws were involved in 12 patients; 19 spinal cord compression. Conclusion The diversity of spinal tuberculosis lesions, lesions can affect the various parts of the vertebral body, MRIT1WI and T2WI mixed signals mainly, comprehensive analysis is helpful to the diagnosis and differential diagnosis.