Yilmaz U
Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 1, 66424, Homburg/Saar, Deutschland.
Radiologe. 2011 Sep;51(9):772-8. doi: 10.1007/s00117-011-2145-7.
Despite highly sensitive imaging techniques, the diagnosis and treatment of spondylodiscitis are often delayed due to a lack of specific symptoms with back pain as the presenting complaint. Late diagnosis and neurological involvement at the time of diagnosis are risk factors for long-term neurological deficits. Unremitting back pain with signs of inflammation should give reason to suspect spondylodiscitis and to rule it out by imaging, especially if risk factors such as diabetes mellitus, malignant neoplasms or immunosuppression are present. Magnetic resonance imaging (MRI) is the imaging procedure of choice with high sensitivity and specificity and typically shows hypointense adjacent vertebrae on T1-weighted images with hyperintense signal on short tau inversion recovery (STIR) sequences and hyperintense disc spaces on T2-weighted images.
尽管有高灵敏度的成像技术,但由于以背痛为主要症状且缺乏特异性症状,脊椎椎间盘炎的诊断和治疗常常被延误。诊断时的晚期诊断和神经受累是导致长期神经功能缺损的危险因素。伴有炎症迹象的持续性背痛应引起怀疑脊椎椎间盘炎并通过影像学检查排除,尤其是存在糖尿病、恶性肿瘤或免疫抑制等危险因素时。磁共振成像(MRI)是首选的成像检查方法,具有高灵敏度和特异性,通常在T1加权图像上显示相邻椎体低信号,在短tau反转恢复(STIR)序列上呈高信号,在T2加权图像上椎间盘间隙呈高信号。