Kim N H, Lee H M, Suh J S
Department of Orthopaedic Surgery and Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
Spine (Phila Pa 1976). 1994 Nov 1;19(21):2451-5. doi: 10.1097/00007632-199411000-00016.
The purposes of this study were to evaluate the nature of the paraspinal soft tissue mass and the location of the lesion involved using magnetic resonance imaging and to correlate these observations with surgical findings.
In the past, tuberculous spondylitis was diagnosed by plain radiography and since the 1970s, computed tomography has been a useful method for assessing tuberculous spondylitis. In contrast to most imaging methods, MRI has the advantages of improved contrast resolution for bone and soft tissues and versatility of direct imaging in multiple planes.
Medical records and magnetic resonance imaging studies of 22 patients with bacteriologically and/or histologically proved tuberculous spondylitis were reviewed. In each patient, the numbers of vertebrae involved were evaluated as well as which columns of vertebrae were affected and the signal intensities of lesions. In addition, an attempt was made to determine if granulation tissue differed from the abscess based on magnetic resonance imaging appearance and to compare the outcome with surgical findings.
The average number of vertebrae involved per patient was 2.8 and T8 and T9 were the vertebrae most frequently affected. The destruction of vertebrae and discs was easily identified in both sagittal and axial planes. The peripheral margins were exclusively enhanced in all cases. Of particular interest, the posterior aspect of the vertebral body was predominantly involved. Mostly the involvement of both anterior and middle columns was noted. With the aid of intravenous administration of magnetic resonance contrast agents, magnetic resonance imaging was highly accurate in distinguishing the granulation tissue from the cold abscess.
Magnetic resonance imaging demonstrated excellent images of bone destruction and soft tissue mass, and provided information in multiple planes, thereby delineating the extent of involvement in tuberculous spondylitis. Magnetic resonance imaging is most helpful in planning a surgical approach to tuberculous spondylitis.
本研究的目的是使用磁共振成像评估椎旁软组织肿块的性质以及所累及病变的位置，并将这些观察结果与手术发现进行关联。
过去，结核性脊柱炎通过X线平片诊断，自20世纪70年代以来，计算机断层扫描一直是评估结核性脊柱炎的有用方法。与大多数成像方法不同，磁共振成像具有提高骨和软组织对比分辨率以及多平面直接成像的多功能性的优点。
回顾了22例经细菌学和/或组织学证实为结核性脊柱炎患者的病历和磁共振成像研究。评估了每位患者受累椎体的数量、受累椎体的柱以及病变的信号强度。此外，试图根据磁共振成像表现确定肉芽组织与脓肿是否不同，并将结果与手术发现进行比较。
每位患者受累椎体的平均数量为2.8个，T8和T9是最常受累的椎体。椎体和椎间盘的破坏在矢状面和轴位面上都很容易识别。所有病例中外周边缘均有强化。特别值得注意的是，椎体的后部主要受累。大多数情况下，前柱和中柱均受累。借助静脉注射磁共振造影剂，磁共振成像在区分肉芽组织和寒性脓肿方面非常准确。
磁共振成像显示了出色的骨破坏和软组织肿块图像，并提供了多平面信息，从而描绘了结核性脊柱炎的受累范围。磁共振成像在规划结核性脊柱炎的手术入路方面最有帮助。
