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脊柱附件结核的MRI影像特征分析

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目的:总结脊柱附件结核的MRI影像特征,以提高对该病的早期诊断能力.方法:回顾性分析2019年1月至2023年10月在某院确诊为脊柱附件结核的21例患者的临床资料及MRI图像,总结其临床基本特征和MRI影像特征.结果:21例患者中,8例出现锥体征阳性、突发下肢无力,13例没有明确的神经功能缺损症状.病灶累及范围从C4至L5椎体,其中腰椎节段受累的脊柱附件结核有13例,胸椎节段受累的有6例,颈椎节段受累的有2例.15例仅累及单个脊柱附件及周边软组织,4例累及2个椎体,2例累及3个椎体.9例为椎弓根受累,8例为椎板受累,部分病例累及棘突、横突和小关节.脊柱附件结核的MRI主要表现为结核累及的骨质T1WI呈稍低信号、T2WI呈稍高信号,增强扫描以边缘强化为主,T2WI抑脂序列及扩散加权成像序列可清晰显示邻近椎旁软组织水肿、脓肿及硬膜内外结核脓肿等特征性表现.结论:MRI能有效发现脊柱附件结核的骨质及软组织等结构的异常,其影像特点具有一定特征性,可作为早期发现脊柱附件结核的首选影像学检查方法及鉴别诊断手段.
Analysis of magnetic resonance imaging features of spinal adnexal tuberculosis
Objective To summarize the magnetic resonance imaging(MRI)features of spinal adnexal tuberculosis in order to improve its early diagnosis.Methods Totally 21 spinal adnexal tuberculosis patients confirmed at some hospital from January 2019 to October 2023 had their clinical data and MRI images analyzed retrospectively to determine the basic clinical characteristics and MRI features.Results Of the 21 patients,8 ones had sudden lower extremity weakness and pyramidal tract signs,and the remaining 13 ones had no significant symptoms of neurologic deficit.The lesion involvement ranged from C4 to L5 vertebrae,with the involvement of lumbar segments in 13 cases,thoracic segments in 6 cases and cervical segments in 2 cases.There were 15 cases that had tuberculosis involving in only a single spinal adnexa and peripheral soft tissue,4 cases in 2 vertebrae and 2 cases in 3 vertebrae.There were 9 cases involving in pedicles,8 cases in vertebral plates and some cases involving in sphenoid process,transverse process or facet joints.The MRI features of spinal adnexal tuberculosis included the tuberculosis-infected bone showing slightly low signals on T1WI while slightly high signals on T2WI,edge enhancement by enhanced scan and edema and abscess of paravertebral soft tissue and intra-and extradural tuberculous abscess displayed clearly by the fat suppression and diffusion weighted imaging sequences of T2WI.Conclusion MRI effectively detects the abnormal signs of bone and soft tissue of spinal adnexal tuberculosis.The MRI findings of spinal adnexal tuberculosis are of characteristics,and MRI can be used as the first choice for imaging examination and differential diagnosis to realize early detection of spinal adnexal tuberculosis.[Chinese Medical Equipment Journal,2025,46(1):55-59]

spinal adnexal tuberculosisspinal tuberculosismagnetic resonance imagingimaging feature

田媛、吴宁、刘杰爱、田梅、邓悦、俞珊、袁小东

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解放军总医院第八医学中心放射科,北京 100194

解放军总医院第八医学中心结核科,北京 100194

脊柱附件结核 脊柱结核 磁共振成像 影像特征

2025

医疗卫生装备
军事医学科学院卫生装备研究所

医疗卫生装备

影响因子:0.776
ISSN:1003-8868
年,卷(期):2025.46(1)