椎间盘炎与脊椎结核的MRI鉴别诊断

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1、万方数据堡兰墅垡兰塑查!!!!至整垫查笙!!塑』坚型!里!E也曼∑21：垫型!：!!!!!!椎间盘炎与脊椎结核的MRI鉴别诊断赵尚开，李银喜，冉华(中国人民解放军第四七八医院医学影像科云南昆明650200)【摘要】目的：探讨椎间盘炎与脊柱结核在MRI上的不同点，从而达到鉴别的目的。方法：20例为经手术后或椎问盘穿刺术后临床证实的椎间盘炎．20例为临床证实的脊柱结核。结果：椎间盘炎与脊柱结核在MRI上的不同点表现在：①临床表现上：椎间盘炎疼痛症状明显．而椎体结核早期可无任何临床症状；②椎问盘改变上：早期椎间盘炎以T。WI加权像髓核内低信号裂隙征消失为明显．椎同盘变狭为后期表现，

2、而椎体结核中后期椎问盘才会有改变；②相邻椎体骨质改变上：椎间盘炎表现为相邻的上、下两个椎体的部分或全部对称性炎性改变．少有椎体骨折．而椎体结核椎体骨质多呈虫蚀样破坏．常侵蚀多个椎体．常合并病理性骨折；④椎旁软组织改变上：椎体结核远比椎问盘炎明显．椎体结核常侵犯到腰大肌、椎管内硬膜外同隙及一侧椎间孔．常使椎管狭窄．而椎间盘炎仅表现为椎问盘旁软组织的轻度肿胀。结论：椎间盘炎与脊柱结核各有其特点．仔细观察椎间盘、椎体以及椎旁软组织上的改变．结合临床已不难鉴别。【关键词】椎间盘炎；脊柱结核；鉴别诊断；磁共振成像中图分类号：R68l；R445．2文献标识码：A文章编号：1006—90l

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