Van Lom K J, Kellerhouse L E, Pathria M N, Moreland S I, Brown J J, Zlatkin M, Sartoris D J, Chevrot A, Resnik C S, Resnick D
Department of Radiology, University of California, San Diego Medical Center 92103.
Radiology. 1988 Mar;166(3):851-5. doi: 10.1148/radiology.166.3.3340783.
To develop criteria to distinguish among pyogenic infection, nonpyogenic infection, and neoplastic processes in the spine by means of computed tomography (CT), the authors retrospectively analyzed 17 cases of pyogenic infection (20 sites), 40 cases of neoplastic disease (56 sites), and five cases of granulomatous infection (eight sites). Reliable criteria for pyogenic infection were complete prevertebral soft-tissue involvement, diffuse osteolytic destruction, gas within both bone and soft tissue, and a process centering on an intervertebral disk. Neoplastic disease was characterized by posterior element involvement, partial or absent prevertebral soft-tissue swelling, and osteoblastic alterations. In a limited number of cases, nonpyogenic infection was characterized by focal lytic bone involvement and marginal sclerosis. Blinded testing of these criteria indicated potential for improved diagnostic accuracy in clinical practice.
为了通过计算机断层扫描（CT）制定区分脊柱化脓性感染、非化脓性感染和肿瘤性病变的标准，作者回顾性分析了17例化脓性感染（20个部位）、40例肿瘤性疾病（56个部位）和5例肉芽肿性感染（8个部位）的病例。化脓性感染的可靠标准包括椎体前软组织完全受累、弥漫性骨质溶解破坏、骨和软组织内均有气体以及以椎间盘为中心的病变过程。肿瘤性疾病的特征是后部结构受累、椎体前软组织部分肿胀或无肿胀以及成骨改变。在少数病例中，非化脓性感染的特征是局限性溶骨性骨受累和边缘硬化。对这些标准进行的盲法测试表明，在临床实践中有可能提高诊断准确性。
