高场磁共振成像在脊柱结核诊断中的临床价值及限度
脊柱；结核；磁共振成像,,],脊柱；结核；磁共振成像,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 评价高场磁共振成像(MRI)在脊柱结核诊断中的临床价值及限度。方法 回顾分析31例经病理证实的脊柱结核MRI资料，其中21例行增强检查。结果 (1)31例患者 67个椎体受累，单椎体1例，2个椎体25例，3个或3个以上椎体5例。T1WI低信号、T2WI高信号为66个，等信号1个。(2)29例31个椎间盘受累，29个椎间隙狭窄或消失，2个信号异常。T1WI低信号，T2WI高信号。(3)31例软组织均受累，16例寒性脓肿形成。T1WI低信号为主，T2WI高信号为主。(4)增强呈不均匀强化。(5)附件未见受累。(6)未能明确有无沙粒样钙化。结论 MRI不能明确有无沙粒样钙化，在脊柱结核的诊断中受到一定限制。椎间盘、软组织受累及附件完整为脊柱结核典型MRI表现，大多数情况下能明确诊断。[关键词] 脊柱；结核；磁共振成像
Clinical value and limitation of MRI in spinal tuberculosis
ZHAO Yong，LI Shen-jiang，WU Hua-min，et al.Department of Imageology,The 88th Hospital of PLA,Taian 271000，China
[Abstract] Objective To investigate the clinical value and limitation of magnetic resonance imaging(MRI) in spinal tuberculosis.Methods 31 patients with histologically confirmed spinal tuberculosis underwent MRI scan,among whom 21 patients underwent MRI scan before and after contrast enhancement.Results (1)67 vertebral bodies were involved in 31 patients.One vertebral body was involved in 1 case,two vertebral bodies in 25 cases and three or more in 5 cases.The lesions showed hypointense in T1 scan.66 vertebrates showed hyperintense in T2 scan and one vertebrate isointense in T2 scan.(2)31 disk space were involved in 29 patients,among which 29 narrowed or disappeared and two showed abnormal signal intensity in MRI scan. The lesions showed hypointense in T1 scan and hyperintense in T2 scan.(3)The soft tissue was revealed abnormal in all 31 patients which appeared hypointense in T1 scan primarily and hyperintense in T2 scan primarily.Cold abscess was revealed in 16 of 31 cases.(4)The lesions showed inhomogeneous enhancement in T1 postcontrast.(5)No abnormal was found in pedicles.(6)The sand-like calcification could not been confirmed.Conclusion The limitation of MRI in spinal tuberculosis is that the sand-like calcification could not been confirmed.The typical findings of spinal tuberculosis in MRI scan is that the disk space and soft tissue are involved and the pedicle is normal.In most cases,the diagnosis can be made. ......
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