Mochizuki T, Kida A, Taniguchi S, Kitamura Y, Nemoto Y, Inoue Y, Onoyama Y
Department of Radiology, Saiseikai Nakatu Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1993 May 25;53(5):535-43.
The aim of this study was to determine the usefulness of MR images obtained with gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) in cases of infectious spondylitis. In our study, four of seven patients were suffering from pyogenic spondylitis while the remaining three had tuberculous spondyitis. In comparison with noncontrast MR images, contrast MR images improved the delineation of disk space infection, extension of the lesions into paravertebral muscles, and the spinal canal, but demarcation of vertebral body lesions and extension of paravertebral fat tissue became less obvious. In the four patients who had pyogenic spondylitis, contrast MR images showed localized, intense vertebral body enhancement adjacent to the end plate and its communication with disk or paravertebral enhancement. In the three patients who had tuberculous spondylitis, contrast MR images showed geographic and/or ring-like enhancement of the vertebral body. We concluded that contrast MR images might be useful for better understanding the pathophysiology of infectious spondylitis and differentiating between tuberculous and pyogenic spondylitis.
本研究的目的是确定钆-二乙三胺五乙酸（Gd-DTPA）增强磁共振成像（MR）在感染性脊柱炎病例中的应用价值。在我们的研究中，7例患者中有4例患有化脓性脊柱炎，其余3例患有结核性脊柱炎。与平扫MR图像相比，增强MR图像改善了椎间盘间隙感染、病变向椎旁肌肉和椎管内扩展的显示，但椎体病变的边界及椎旁脂肪组织的扩展显示欠清晰。在4例化脓性脊柱炎患者中，增强MR图像显示终板相邻部位椎体局限性、强化明显，并与椎间盘或椎旁强化相连。在3例结核性脊柱炎患者中，增强MR图像显示椎体呈地图样和/或环状强化。我们得出结论，增强MR图像可能有助于更好地理解感染性脊柱炎的病理生理，并鉴别结核性和化脓性脊柱炎。
