CAJ | 학술논문

目的：探讨脊柱结核与化脓性脊柱炎 CT 征象差别。方法回顾性分析32例脊柱结核与30例化脓性脊柱炎患者的 CT表现,对不同征象进行记录和统计学分析。结果32例脊柱结核累及71个脊椎,30例化脓性脊柱炎累及59个脊椎。胸椎受累脊柱结核发生率60.56%(43/71),高于化脓性脊柱炎(25.42%,15/59),P <0.05。腰椎受累脊柱结核发生率33.80%(24/71),低于化脓性脊柱炎(61.02%,36/59),P <0.05。虫蚀型骨质破坏脊柱结核发生率9.90%(7/71),低于化脓性脊柱炎(44.07%,26/59), P <0.05。碎片型骨质破坏脊柱结核发生率19.72%(14/71),高于化脓性脊柱炎(3.39%,2/59),P <0.05。广泛骨硬化脊柱结核出现率52.11%(37/71),高于化脓性脊柱炎(22.03%,13/59),P <0.05。矢状位上受累椎体高度小于正常椎体高度1/2者脊柱结核发生率16.90%(12/71),低于化脓性脊柱炎(62.71%,37/59),P <0.05。病灶内钙质样高密度影脊柱结核发生率50.70%(36/71),高于化脓性脊柱炎(20.34%,12/59),P <0.05。附件受累脊柱结核发生率25.35%(18/71),高于化脓性脊柱炎(8.47%,5/59),P <0.05。椎旁异常软组织伴钙化脊柱结核发生率60.00%(18/30),高于化脓性脊柱炎(20.00%,5/25),P <0.05。结论脊柱结核与化脓性脊柱炎二者的 CT 征象具有一定特征,结合临床特点可及时作出鉴别诊断。
목적：탐토척주결핵여화농성척주염 CT 정상차별。방법회고성분석32례척주결핵여30례화농성척주염환자적 CT표현,대불동정상진행기록화통계학분석。결과32례척주결핵루급71개척추,30례화농성척주염루급59개척추。흉추수루척주결핵발생솔60.56%(43/71),고우화농성척주염(25.42%,15/59),P <0.05。요추수루척주결핵발생솔33.80%(24/71),저우화농성척주염(61.02%,36/59),P <0.05。충식형골질파배척주결핵발생솔9.90%(7/71),저우화농성척주염(44.07%,26/59), P <0.05。쇄편형골질파배척주결핵발생솔19.72%(14/71),고우화농성척주염(3.39%,2/59),P <0.05。엄범골경화척주결핵출현솔52.11%(37/71),고우화농성척주염(22.03%,13/59),P <0.05。시상위상수루추체고도소우정상추체고도1/2자척주결핵발생솔16.90%(12/71),저우화농성척주염(62.71%,37/59),P <0.05。병조내개질양고밀도영척주결핵발생솔50.70%(36/71),고우화농성척주염(20.34%,12/59),P <0.05。부건수루척주결핵발생솔25.35%(18/71),고우화농성척주염(8.47%,5/59),P <0.05。추방이상연조직반개화척주결핵발생솔60.00%(18/30),고우화농성척주염(20.00%,5/25),P <0.05。결론척주결핵여화농성척주염이자적 CT 정상구유일정특정,결합림상특점가급시작출감별진단。
Objective This study was to investigate the computed tomography(CT)features differentiating tuberculous spondyli-tis from pyogenic spondylitis.Methods The CT features in 32 patients with tuberculous spondylitis and 30 patients with pyogenic spondylitis were retrospectively reviewed,and statistically analyzed.Results In 32 cases of tuberculous spondylitis,71 vertebra were involved.In 30 cases of pyogenic spondylitis,59 vertebra were involved.The incidence of thoracic vertebra involvement in tuberculous spondylitis was 60.56% (43/71),which was higher than that in pyogenic spondylitis (25.42%,1 5/59)(P <0.05).The incidence of lumbar vertebra involvement in tuberculous spondylitis was 33.80% (24/71 ),which was lower than that in pyogenic spondylitis (61.02%,36/59)(P <0.05).The incidence of the worm-eaten type of bone destruction in tuberculous spondylitis was 9.90% (7/71),which was lower than that in pyogenic spondylitis (44.07%,26/59)(P <0.05).The incidence of the fragmentary type of bone destruction in tuberculous spondylitis was 1 9.72%(14/71 ),which was higher than that of in pyogenic spondylitis (3.39%,2/59) (P <0.05).The incidence of large osteosclerosis in tuberculous spondylitis was 52.1 1%(37/71),which was higher than that in pyo-genic sp-ondylitis (22.03%,13/59),(P <0.05).The incidence of the involved vertebral height on sagital CT scan (less than the 1/2 of the normal vertebral height)in tuberculous spondylitis was 1 6.9% (12/71),which was lower than that in pyogenic spondylits (62.71%,37/59)(P <0.05).The incidence of patchy high density shadow in tuberculous spondylitis was 50.7% (36/71 ),which was higher than that in pyoge-nic spondylitis (20.34%,12/59)(P <0.05.)The incidence of the involvement of the appendages in tu-berculous spondylitis was 25.35% (18/71),which was higher than that in pyogenic spondylitis (8.47%,5/59)(P <0.05).The inci-dence of paravertebral abnormal soft tissue with calcification in tuberculous spondylitis was 60.00%(18/30),which was higher than that in pyogenic spondylitis(20.00%,5/25 )(P < 0.05 ).Conclusion Tuberculous spondylitis and pyogenic spondylitis have some characteristic imaging features,combined with the clinical signs differentiation diagnosis can be made each other.