儿童脊柱结核的MRI特征分析  

MRI Diagnosis of Spinal Tuberculosis in Children

作　　者：张文娟[1] 马炎旭[1] 何家维[1] 严志汉[1] 

机构地区：[1]温州医学院附属第二医院/育英儿童医院放射科,325000

出　　处：《医学研究杂志》2012年第9期165-168,共4页Journal of Medical Research

摘　　要：目的探讨MRI在儿童脊柱结核诊断和随访中的应用价值。方法对26例脊柱结核患儿的MRI资料进行回顾性分析,着重分析病变的部位、信号及其随访特征。结果 26例中发现87个椎体受累,其中颈椎16个,胸椎32个,腰椎21个,骶尾椎18个;累及单个椎体6例,多个椎体20例。病变椎体早期呈稍长T1长T2信号,中晚期椎体不规则破坏,呈混杂长T1长T2信号,在STIR呈明显高信号,病变椎体呈楔形、变扁或融合等改变;随访12例中,9例出现脊柱后凸畸形。26例中,22例出现椎间盘形态及信号改变,表现为椎间隙狭窄或消失;22例出现椎旁软组织肿胀、脓肿,8例合并硬膜囊或脊髓受压。结论 MRI不仅有助于儿童脊柱结核早期诊断,而且在判断病变类型、范围,以及病变预后等方面为临床提供更多的信息。Objective To investigate the value of diagnosis and follow - up visit with MRI in pediatric spinal tuberculosis. Methods MR imagings in 26 children with spinal tuberculosis were analyzed retrospectively. Results Out of 26 patients,87 vertebral bodies were affected in total,including 16,32,21 and 16 vertebral bodies separately in the cervical, thoracic, lumbar and sacrococcygeal spine. Totally 6 cases were limited to a single vertebral body, and 20 involved multiple vertebral levels. The vertebral body lesions showed a little long T1 and long T2 signal at the early stage. At the medium or late stage, the vertebral bodies were destructed with mixed long T1 and long T2 signal, and appeared notably high intensity on STIR sequence. At last, the deformed vertebral bodies became wedged, flat or merged, and 9 out of 12 followed - up cases showed kyphosis obviously. As far as to signal and shape changed in 26 cases, the disc were poorly visualized or lost in 22, paraspinal soft - tissue masses and abcess formation were observed in 22,intraspinal compression of the dural sac and spinal cord were seen in 8. Conclusion MRI can not only single out the children spinal tuberculosis earlier,but also play a great role in the judgement of the type, distribution and prognosis which may give more information to the clinical.

关 键 词：儿童 脊柱 结核 磁共振成像 

分 类 号：R743.34[医药卫生—神经病学与精神病学]