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目的:探讨脊柱结核多层螺旋CT影像特征及其鉴别诊断的价值。方法 :回顾性分析本院经临床及手术病理证实的脊柱结核57例的多层螺旋CT资料,年龄10~87岁,其中男39例,女18例。对所有病例均进行多层螺旋CT扫描。结果:57例脊柱结核中,颈椎2例、胸椎24例、腰椎22例、胸腰段9例。单个椎体受累5例,多个椎体受累52例。CT征像为:1椎体骨质破坏,破坏区死骨形成;2椎间盘破坏、椎间隙变窄;3椎旁脓肿,其内可有钙化灶。结论:骨破坏、破坏区内小死骨、椎间隙变窄、椎前或旁腰大肌脓肿构成脊柱结核特征性CT表现。多层螺旋CT对脊柱结核诊断及鉴别诊断具有重要价值。
Objective: To investigate the features and differential diagnosis of spinal tuberculosis multi-slice spiral CT images. Methods: A retrospective analysis of 57 cases of spinal tuberculosis confirmed by clinical and surgical pathology in our hospital from 10 to 87 years old, including 39 males and 18 females. Multi-slice spiral CT was performed on all cases. Results: In 57 cases of spinal tuberculosis, 2 cases were cervical spine, 24 cases were thoracic spine, 22 cases were lumbar spine and 9 cases were thoracolumbar spine. A single vertebral involvement in 5 cases, multiple vertebral involvement in 52 cases. CT signs as follows: 1 vertebral bone destruction, destruction of sequestrum formation; 2 intervertebral disc destruction, intervertebral space narrowing; 3 paraspinal abscess, which may have calcification. Conclusion: The destruction of bone, the destruction of small septa in the area, the intervertebral space narrowing, prevertebral or paraspinal myasthenia abscess constitute CT manifestations of spinal tuberculosis. Multi-slice spiral CT has important value in the diagnosis and differential diagnosis of spinal tuberculosis.