儿童椎间盘炎与脊柱结核的MRI比较  

Comparation of MRI features in the childhood discitis and spinal tuberculosis

作　　者：温洋[1] 彭芸[1] 尹光恒[1] 刘玥[1] 张玥[1] 段晓岷[1] 

机构地区：[1]首都医科大学附属北京儿童医院影像中心磁共振成像设备与技术北京市重点实验室,北京100045

出　　处：《医学影像学杂志》2016年第3期507-510,共4页Journal of Medical Imaging

基　　金：首都医科大学基础-临床科研合作基金(13JL49);国家自然科学基金面上项目(31271161)

摘　　要：目的比较儿童椎间盘炎与脊柱结核的MRI表现,提高鉴别诊断水平。方法收集经临床证实且有MRI资料的儿童椎间盘炎7例,儿童脊柱结核14例,分析比较其MRI征象。结果儿童椎间盘炎7例(100%)受累椎体及椎间盘数均为2+1,而脊柱结核9例(64%)是,余5例累及范围更大;附件水肿脊柱结核多见,为12例(86%),椎间盘炎4例(57%)。脊柱结核椎体异常信号几乎充满整个椎体,椎间盘炎相对范围较小(P=0.006)。椎间盘炎均无椎体变扁及脊柱后凸,脊柱结核7例(50%)有(P=0.030)。相比椎间盘炎,脊柱结核椎旁软组织异常发生率高、范围较大、信号较混杂(P=0.026,0.002,0.005)。结论儿童椎间盘炎与脊柱结核各有一定MRI特点,多数不难鉴别。Objective To compare the MRI features between the discitis and spinal tuberculosis in children and to improve the level of differential diagnosis .Methods The MR imaging manifestations of 7 patients with clinically proved discitis and 13 pa-tients with spinal tuberculosis were retrospectively analyzed and compared .Results The involvement of one intervertebral disc with 2 adjacent vertebrae was demonstrated in all the 7 cases （100%） with discitis, in 9 cases （64%） with spinal tuberculosis , and the rest of the tubercular cases had more discs and vertebrae involved .Spinal posterior components edema tended to be more common in tuberculosis （12 cases, 86%） than in discitis （4 cases, 57%）.The abnormal signal in the adjacent vertebral body tended to be greater range in tuberculosis than in discitis （ P =0.006）.Vertebral body height narrowing and kyphosis were seen in 7 cases with tuberculosis and none in discitis （ P =0.030）.Paravertebral soft tissue abnormalities tended to be more frequent and broader and have mixed signals in tuberculosis than in discitis （ P =0.026, 0.002, 0.005）.Conclusion The childhood discitis and spinal tuberculosis have their own characteristics .And the differential diagnosis will not be difficult in most cases .

关 键 词：儿童 椎间盘炎 脊柱 结核 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R726[医药卫生—诊断学]