Desai S S
University of Bombay, India.
J Bone Joint Surg Br. 1994 Nov;76(6):863-9.
MRI was performed at three centres in Bombay on 24 patients clinically suspected of tuberculosis of the spine but with normal radiographs. There were 11 males and 13 females and their average age was 24 years (11 to 60). 99mTc bone scans were done in 16 patients before MRI. Eleven patients had the diagnosis confirmed by biopsy and the remainder all responded rapidly to specific antituberculous chemotherapy. On T1-weighted images there was a decrease in signal intensity of the involved bone and soft tissues; on T2-weighted images there was increased signal intensity. Depending on the stage of the disease, three different patterns of infection were revealed: osteitis, osteitis with an abscess, and osteitis with or without an abscess plus discitis. The anatomical pattern of involvement, particularly of the soft tissues and the discs, is specific for tuberculous disease. The ability of MRI to detect tuberculosis of the spine earlier than other techniques could reduce bone destruction and deformity and diminish the need for surgical intervention. Despite the specificity of the patterns revealed by MRI, biopsy is recommended during the stage of osteitis to confirm the diagnosis.
在孟买的三个中心，对24例临床怀疑患有脊柱结核但X线片正常的患者进行了磁共振成像（MRI）检查。其中男性11例，女性13例，平均年龄24岁（11至60岁）。16例患者在进行MRI检查前做了99m锝骨扫描。11例患者经活检确诊，其余患者均对特异性抗结核化疗迅速产生反应。在T1加权图像上，受累骨骼和软组织的信号强度降低；在T2加权图像上，信号强度增加。根据疾病阶段，发现了三种不同的感染模式：骨炎、伴有脓肿的骨炎、伴有或不伴有脓肿及椎间盘炎的骨炎。受累的解剖模式，尤其是软组织和椎间盘的模式，是结核疾病所特有的。MRI比其他技术更早检测出脊柱结核的能力可以减少骨质破坏和畸形，并减少手术干预的需求。尽管MRI显示的模式具有特异性，但在骨炎阶段仍建议进行活检以确诊。
