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目的探讨磁共振(magnetic resonance imaging,MRI)常规序列在脊柱结核诊断的主要特征,评估MRI在该病的应用价值,为临床诊断与鉴别诊断提供依据。方法回顾性分析2011年1月至2014年2月的符合入组标准的113份病例。其中脊柱结核36例,对照组77例。平均年龄(61±13)岁。对所有病例的年龄、性别、症状、体征、病史及初次检查MRI特征进行诊断脊柱结核的灵敏度和特异度及准确度分析。结果发病年龄、性别和神经障碍的组间差异无统计学意义。脊柱结核组中差异有统计学意义的MRI特征准确度:相邻节段受累(77.9%)、终板破坏(72.6%)、脊柱周围脓肿(80.5%)、短时反转恢复(short time inversion recovery,STIR)序列病变累及椎体前部(70.8%)等。结论在结核性脊柱炎的诊断中,MRI具有重要的作用。相邻节段受累、终板破坏、脊柱周围脓肿以及STIR序列病变累及椎体前部等特征对结核性脊柱炎的诊断具有重要意义。疾病既往史是诊断脊柱疾病的重要特征之一。
Objective To investigate the main features of magnetic resonance imaging (MRI) in the diagnosis of spinal tuberculosis and to evaluate the value of MRI in the diagnosis of this disease and provide the basis for clinical diagnosis and differential diagnosis. Methods Retrospective analysis of 113 cases met the inclusion criteria from January 2011 to February 2014. Including 36 cases of spinal tuberculosis, control group of 77 cases. The average age (61 ± 13) years old. The sensitivity, specificity, and accuracy of the diagnosis of spinal tuberculosis in all cases were analyzed for age, gender, symptoms, signs, medical history, and primary MRI features. Results There were no significant differences in age, gender and neurological disorders between groups. Significantly different MRI features in the spinal tuberculosis group were: adjacent segment involvement (77.9%), endplate destruction (72.6%), peripheral abscess (80.5%), short time inversion Recovery, STIR) sequence lesions involving the anterior vertebral body (70.8%) and so on. Conclusion MRI has an important role in the diagnosis of tuberculous spondylitis. Adjacent segment involvement, endplate destruction, abscess around the spine, and the involvement of the anterior vertebral segment of the STIR sequence are important for the diagnosis of tuberculous spondylitis. Past disease history is one of the important characteristics of the diagnosis of spinal disease.