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目的探讨脊椎结核的MRI表现及其诊断价值。方法对27例脊椎结核行矢状位T1加权、T2加权,横断面T1加权,部分加冠状面T1加权。12例行GD-DTPA增强扫描,行横断面、矢状面及冠状面T1加权扫描,观察椎体、椎间盘和冷脓肿的信号变化和增强后强化情况。结果椎体终板破坏呈长T1长T2信号改变,其中T2IW多为混杂高信号;早期椎间盘信号可正常或只出现退变,晚期椎间盘破坏呈明显不均匀长T2信号;椎旁冷脓肿呈长T1长T2均匀无结构信号,境界常清楚,冷脓肿上下跨越范围大;GD-DTPA增强扫描可清楚显示冷脓肿周围纤维肉芽组织及椎管内侵犯。结论MRI能清楚显示脊柱结核椎体骨炎,椎间盘破坏及椎旁脓肿,对脊柱结核有确切的诊断价值。
Objective To investigate the MRI findings and diagnostic value of spinal tuberculosis. Methods Twenty-seven cases of vertebral tuberculosis underwent sagittal T1 weighted, T2 weighted, T1 transected, and weighted coronal T1. Twelve patients underwent enhanced GD-DTPA scan, and the transverse, sagittal and coronal T1 weighted scans were performed to observe the signal changes and enhancement after vertebral body, disc and cold abscess. Results The changes of long T1 long T2 signal were observed in the endplate of vertebral body. Among them, T2IW was mostly mixed high signal. The signal of early disc degeneration was normal or only degenerated, and the late disc disruption was obviously uneven T2 signal. The paravertebral cold abscess was long T1 long T2 uniform structure-free signal, the state often clear, cold abscess up and down across the large; GD-DTPA enhanced scan can clearly show cold abscess around the granulation tissue and spinal violations. Conclusion MRI can clearly show the spinal tuberculosis vertebral osteitis, disc destruction and paravertebral abscess, the exact diagnosis of spinal tuberculosis.