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1、萬方數(shù)據(jù)堡蘭墅垡蘭塑查!!!!至整墊查笙!!塑』堅(jiān)型!里!E也曼∑21：墊型!：!!!!!!椎間盤炎與脊椎結(jié)核的MRI鑒別診斷趙尚開，李銀喜，冉華(中國人民解放軍第四七八醫(yī)院醫(yī)學(xué)影像科云南昆明650200)【摘要】目的：探討椎間盤炎與脊柱結(jié)核在MRI上的不同點(diǎn)，從而達(dá)到鑒別的目的。方法：20例為經(jīng)手術(shù)后或椎問盤穿刺術(shù)后臨床證實(shí)的椎間盤炎．20例為臨床證實(shí)的脊柱結(jié)核。結(jié)果：椎間盤炎與脊柱結(jié)核在MRI上的不同點(diǎn)表現(xiàn)在：①臨床表現(xiàn)上：椎間盤炎疼痛癥狀明顯．而椎體結(jié)核早期可無任何臨床癥狀；②椎問盤改變上：早期椎間盤炎以T。WI加權(quán)像髓核內(nèi)低信號(hào)裂隙征消失為明顯．椎同盤變狹為后期表現(xiàn)，
2、而椎體結(jié)核中后期椎問盤才會(huì)有改變；②相鄰椎體骨質(zhì)改變上：椎間盤炎表現(xiàn)為相鄰的上、下兩個(gè)椎體的部分或全部對(duì)稱性炎性改變．少有椎體骨折．而椎體結(jié)核椎體骨質(zhì)多呈蟲蝕樣破壞．常侵蝕多個(gè)椎體．常合并病理性骨折；④椎旁軟組織改變上：椎體結(jié)核遠(yuǎn)比椎問盤炎明顯．椎體結(jié)核常侵犯到腰大肌、椎管內(nèi)硬膜外同隙及一側(cè)椎間孔．常使椎管狹窄．而椎間盤炎僅表現(xiàn)為椎問盤旁軟組織的輕度腫脹。結(jié)論：椎間盤炎與脊柱結(jié)核各有其特點(diǎn)．仔細(xì)觀察椎間盤、椎體以及椎旁軟組織上的改變．結(jié)合臨床已不難鑒別?！娟P(guān)鍵詞】椎間盤炎；脊柱結(jié)核；鑒別診斷；磁共振成像中圖分類號(hào)：R68l；R445．2文獻(xiàn)標(biāo)識(shí)碼：A文章編號(hào)：1006—90l
3、l(2010)ll—1700～03ThedifferentiaIdia印吣iso“he施cit萱sandspi艙ltubercuI惦is蚰MRIZHA0S婦行礙-婦i。LjH行一“．RANH“口DP戶口以，’l已州o，J優(yōu)n暑i珂g。T．^P478脅H∞戶i紐Zo，PLA．K“以優(yōu)i行g(shù)650200．P．R．C^i開口【Abstract】objective：TodiscussthedifferencesbetweetthediscitisandspinaltuberculosisonMRI，soastoachievethepurposeofidentifying．I¨etho
4、cb：20casesofdiscitiswereprovedbysurgeryorafterthevertebraldiscpunctureclinically．()ther20casesofspinaltuberculosiswereconf．rmedc“nically．Results：Thedifferencesbetweetdiscitisandspinaltubercu—losisonMRlare：①Clinicalmanifestations：theintervertebraIdiscinflammationispain．whilethevertebraltuber
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6、tuberculosisonmid—andlatestage；③Changesintheadjacentvertebralbone：theperformanceofthevertebraldiscistheadjacentupperandlowervertebraIbodypartsora兒ofthesymmetryofinflammatory．fewfracture．whiletheveftebralboneintuberculosisismotheatenbonedestruction．oftenmultiplevertcbralerosion．oftenassociat
7、edwithpathologicalfracture；④Changesintheparaspi—nalsofttissue：thereismoreobviouschangesintheparaspinalsofttissLleintuberculosisthanvertebraldiscitis．VertebraltuberculosisofteninvolvedthepsoasmajormuscIe．Intraspinalepiduralspaceandthesideofrheintervertebr
