磁共振常规序列在结核性脊柱炎诊断中的应用  

A study on applications of general sequencing of conventional magnetic resonance imaging in tuberculous spondylitis

作　　者：艾琪勇 罗越[1] 蔡林[1] 

机构地区：[1]武汉大学中南医院骨科,湖北430071

出　　处：《中国骨与关节杂志》2015年第11期870-874,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨磁共振(magnetic resonance imaging,MRI)常规序列在脊柱结核诊断的主要特征,评估MRI在该病的应用价值,为临床诊断与鉴别诊断提供依据。方法回顾性分析2011年1月至2014年2月的符合入组标准的113份病例。其中脊柱结核36例,对照组77例。平均年龄(61±13)岁。对所有病例的年龄、性别、症状、体征、病史及初次检查MRI特征进行诊断脊柱结核的灵敏度和特异度及准确度分析。结果发病年龄、性别和神经障碍的组间差异无统计学意义。脊柱结核组中差异有统计学意义的MRI特征准确度:相邻节段受累(77.9%)、终板破坏(72.6%)、脊柱周围脓肿(80.5%)、短时反转恢复(short time inversion recovery,STIR)序列病变累及椎体前部(70.8%)等。结论在结核性脊柱炎的诊断中,MRI具有重要的作用。相邻节段受累、终板破坏、脊柱周围脓肿以及STIR序列病变累及椎体前部等特征对结核性脊柱炎的诊断具有重要意义。疾病既往史是诊断脊柱疾病的重要特征之一。Objective To evaluate characteristics of tuberculous spondylitis on conventional magnetic resonance imaging（ MRI） and their diagnosis value. Methods One hundred and thirteen cases, pathologically and clinically proven, including pyogenic spondylitis group（ 36 cases） and control group（ 77 cases） were retrospectively analyzed from January, 2011 to February 2014. The average age was（ 61±13） years old. Age, gender, symptoms, physical signs, history, sensitivity and specificity and accuracy in the initial inspection MRI diagnosis of spinal tuberculosis were analyzed. Results There were no significant differences in age, gender and neurological disorders between 2 groups. Statistically significant accuracy of MRI existed in the spinal tuberculosis group. MR imaging accuracy： involvement of two adjacent vertebral bodies（ 77.9%）, endplate disruption（ 72.6%）, abscess around the spine（ 80.5%）, short time inversion recovery（ STIR） sequence lesion and involvement of anterior vertebras（ 70.8%） and so on. Conclusions Conventional MRI is a significant technique in the diagnosis of tuberculous spondylitis. Involvement of adjacent vertebral bodies, endplate disruption, abscess around the spine, STIR sequence lesion and involvement of anterior vertebras are important characteristics on MRI for tuberculous spondylitis diagnosis. Besides, clinical history is important as well.

关 键 词：核磁共振 结核 脊柱 脊柱炎 诊断 

分 类 号：R529.2[医药卫生—内科学]