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颈椎结核16例影像学表现与分析

         

摘要

Objective :To investigate imaging features of cervical tuberculosis .Methods :Imaging informa-tion of 16 patients with cervical tuberculosis by pathology were retrospectively analyzed .Results :In this group of pa-tients ,There was 14 cases of vertebral body-edge type ,and 2 cases of vertebral body-central .A total of 27 vertebrae were mainly concentrated in the lower cervical spine .The fifth cervical vertebra had the highest incidence .There were changes in 13 cases with body-edge type of intervertebral disc in a total of 14 cases .And 2 patients with verte-bral body-central type showed no significant changes of the intervertebral disc .X-ray examination revealed that the density of vertebral bodies was inhomogeneous in all 16 patients .CT showed that vertebral bodies were of inhomoge-neous density ,often accompanying cloddy or sand-like dead bones .On MRI T1WI ,most damaged vertebral bodies showed hypointensity ,a few showed low-mixed signals .Destruction of vertebral bodies showed heterogeneous hy-perintensity while edematous area showed higher signal . Homogeneous or inhomogeneous enhancement was ob-served in 5 vertebral bodies in 2 patients ,and edge enhancement was prominent .Conclusion :Age of onset of cervical tuberculosis concentrated on under the age of 30 and over the age of 50 ,mainly involving the lower cervical lesions , especially the fifth cervical vertebra .The combination of multiple imaging methods have high diagnostic value and preoperative evaluation value of cervical tuberculosis .%目的:探讨颈椎结核的影像学表现。方法:对颈椎影像学检查并经病理证实的颈椎结核患者16例进行回顾性分析。结果:16例中,椎体边缘型14例,椎体中心型2例;共累及27个椎体,主要集中在下颈段,以第5颈椎最为高发;14例边缘型颈椎结核中,13例出现椎间盘改变,2例中心型结核患者均未出现明显椎间盘改变;16例患者椎体破坏X线、C T 均表现为骨质密度高低不均,CT可见块状或砂粒样死骨形成,M RI显示多数病变椎体 T1WI呈低信号,少数呈等低混杂信号,T2WI上骨质破坏区多呈不均匀较高信号,炎性水肿区呈略高信号。2例患者行增强扫描,受累的5个椎体可见轻到中度均匀或不均匀强化,周边强化比较明显。结论:颈椎结核发病年龄集中于30岁以下及50岁以上,病变主要累及下颈段,其中以第5颈椎最为多发。多种影像学检查方法联合使用对颈椎结核的诊断和术前评估有十分重要的意义。

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