中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2008年
7期
688-691
,共4页
TANG Xiao-feng%任有宽%MA Heng%周承涛%MU Ren-qi%孙晓苑
TANG Xiao-feng%任有寬%MA Heng%週承濤%MU Ren-qi%孫曉苑
TANG Xiao-feng%임유관%MA Heng%주승도%MU Ren-qi%손효원
脊柱炎%椎间盘炎%骨疾病,感染性%磁共振成像
脊柱炎%椎間盤炎%骨疾病,感染性%磁共振成像
척주염%추간반염%골질병,감염성%자공진성상
Spondylitis%Discitis%Bone diseases,infectious%Magnetic resonance imaging
目的 探讨椎间型化脓性脊椎炎的MRI表现特征.方法 对12例经手术证实、6例经临床确诊的椎间型化脓性脊椎炎MRI表现进行回顾性分析.18例患者均常规平扫,其中11例同时进行了增强扫描.结果 18例患者中16例单发、2例多发.MRI表现:(1)椎间盘改变:17例T2WI号增高,呈核裂消失征,15例椎间盘积液,4例椎间盘穿孔,7例椎间隙狭窄.(2)相邻终板及椎体改变:18例均有终板下骨质破坏及椎体非破坏区骨髓水肿,17例终板破坏,16例示终板掩盖征.(3)椎旁软组织改变:18例均有椎旁软组织肿胀,4例形成厚壁小脓肿.(4)椎管与附件改变:12例椎管受累,表现为硬脊膜囊前间隙增宽,信号混杂,5例形成脓肿,未见附件受累.(5)增强扫描:11例中破坏区旱条块状强化4例,结节样强化和环状强化各2例,不强化3例;椎体非破坏区及椎周软组织不均匀强化;6例硬脊膜囊旱线样强化,10例硬脊膜囊前间隙呈斑片状强化.结论 椎间型化脓性脊椎炎MRI表现具有特征性,密切结合临床和MRI表现是诊断的关键.
目的 探討椎間型化膿性脊椎炎的MRI錶現特徵.方法 對12例經手術證實、6例經臨床確診的椎間型化膿性脊椎炎MRI錶現進行迴顧性分析.18例患者均常規平掃,其中11例同時進行瞭增彊掃描.結果 18例患者中16例單髮、2例多髮.MRI錶現:(1)椎間盤改變:17例T2WI號增高,呈覈裂消失徵,15例椎間盤積液,4例椎間盤穿孔,7例椎間隙狹窄.(2)相鄰終闆及椎體改變:18例均有終闆下骨質破壞及椎體非破壞區骨髓水腫,17例終闆破壞,16例示終闆掩蓋徵.(3)椎徬軟組織改變:18例均有椎徬軟組織腫脹,4例形成厚壁小膿腫.(4)椎管與附件改變:12例椎管受纍,錶現為硬脊膜囊前間隙增寬,信號混雜,5例形成膿腫,未見附件受纍.(5)增彊掃描:11例中破壞區旱條塊狀彊化4例,結節樣彊化和環狀彊化各2例,不彊化3例;椎體非破壞區及椎週軟組織不均勻彊化;6例硬脊膜囊旱線樣彊化,10例硬脊膜囊前間隙呈斑片狀彊化.結論 椎間型化膿性脊椎炎MRI錶現具有特徵性,密切結閤臨床和MRI錶現是診斷的關鍵.
목적 탐토추간형화농성척추염적MRI표현특정.방법 대12례경수술증실、6례경림상학진적추간형화농성척추염MRI표현진행회고성분석.18례환자균상규평소,기중11례동시진행료증강소묘.결과 18례환자중16례단발、2례다발.MRI표현:(1)추간반개변:17례T2WI호증고,정핵렬소실정,15례추간반적액,4례추간반천공,7례추간극협착.(2)상린종판급추체개변:18례균유종판하골질파배급추체비파배구골수수종,17례종판파배,16례시종판엄개정.(3)추방연조직개변:18례균유추방연조직종창,4례형성후벽소농종.(4)추관여부건개변:12례추관수루,표현위경척막낭전간극증관,신호혼잡,5례형성농종,미견부건수루.(5)증강소묘:11례중파배구한조괴상강화4례,결절양강화화배상강화각2례,불강화3례;추체비파배구급추주연조직불균균강화;6례경척막낭한선양강화,10례경척막낭전간극정반편상강화.결론 추간형화농성척추염MRI표현구유특정성,밀절결합림상화MRI표현시진단적관건.
Objective To explore MRI findings of intervertebral suppurative spondylitis. Methods MRI findings of intervertebral suppurative spondylitis in 12 cases proved by surgery and 6 cases defined by clinical features were retrospectively analyzed. The MRI protocol included un-enhanced conventional scan in 18 cases and contrast-enhanced scan in 11 cases. Results Of the 18 cases, single focus was found in 16 cases, and multiple loci were seen in 2 cases. MRI findings included (1) Disappearance sign of nuclear crevice in 17 cases, accumulated fluid sign of intervertebral disc in 15 cases, intervertebral disc perforation in 4 cases, and intervertebral space narrowing in 7 cases. (2) Bone destruction under end plate and marrow oedema were shown in 18 cases, 17 cases had end plate destruction, 16 cases had covered sign of end plate.(3) Paraspinal soft tissue swelling was shown in 18 cases, in which thick wall microabscess was formed in 4 cases. (4) Vertebral canal was involved in 12 cases, vertebral canal abscess was formed in 5 cases.(5) Lump enhancement was demonstrated in 4 cases, nodular enhancement in 2, and ring-like enhancement in 2, respectively. No enhancement was seen in 3 cases. Dural sac linear enhancement was shown in 6 cases, and patchy enhancement in the anterior dural sac was shown in 10 cases. Conclusion Intervertebral suppurative spondytitis had characteristic MRI findings, and the key to correct diagnosis was to combine MRI finding with clinical characteristics.