Hovi I, Lamminen A, Salonen O, Raininko R
Department of Radiology, Helsinki University Hospital, Finland.
Acta Radiol. 1994 Nov;35(6):532-40.
The findings on MR imaging of 28 patients with spinal infection and 40 patients with spinal malignant disease were compared. Spinal infections involved one to 4 vertebrae, usually (23/28) 2 vertebrae. The posterior elements were involved with certainty in 26/40 patients with malignancy but in none with infection. In the latter group, the posterior elements might have been involved in 3/28. The intervertebral disk between the infected vertebrae was involved in 26/28 patients and 21/28 had a paravertebral mass. Spinal malignancies affected the vertebrae alone in 19 patients and paravertebral extension was found in 21/40 patients. The intervertebral disk was involved only in one patient with malignancy. The differences in the distribution of the MR findings between spinal infection and spinal malignancy were highly significant (p < 0.001). The highest signal intensity of the infectious lesions on T2-weighted images was equal to or higher than that of the cerebrospinal fluid (CSF) in 26/28 patients. In contrast, the signal intensity of the malignant lesions was hypointense as compared to the CSF in 29/40 patients (p < 0.001). MR is a useful method for differentiating between infection and malignancy in the lower spine; T2-weighted images are especially valuable for differentiation.
对28例脊柱感染患者和40例脊柱恶性疾病患者的磁共振成像（MR）检查结果进行了比较。脊柱感染累及1至4个椎体，通常（23/28）为2个椎体。在40例恶性疾病患者中，有26例确定累及后部结构，而感染患者无一例累及。在后一组中，28例中有3例可能累及后部结构。28例感染患者中有26例感染椎体之间的椎间盘受累，28例中有21例有椎旁肿块。19例脊柱恶性肿瘤仅累及椎体，40例中有21例发现有椎旁扩展。仅1例恶性肿瘤患者的椎间盘受累。脊柱感染和脊柱恶性肿瘤在MR表现分布上的差异具有高度显著性（p<0.001）。28例患者中，26例感染性病变在T2加权图像上的最高信号强度等于或高于脑脊液（CSF）。相比之下，40例患者中有29例恶性病变的信号强度相对于脑脊液呈低信号（p<0.001）。MR是鉴别下脊柱感染和恶性肿瘤的有用方法；T2加权图像对鉴别尤其有价值。
