目的：探讨脊柱畸形性骨炎的CT及MRI影像特征。方法：回顾性分析经手术或穿刺病理证实的6例畸形性骨炎患者的临床资料及影像学表现，6例行CT检查，4例行MRI检查，1例行核素骨扫描。结果：6例病例中2例单发，4例多发，共计12个病灶，位于腰椎9个，胸椎3个。CT发现8个病灶椎体及附件呈网格状低密度区，骨小梁增粗，2个病灶弥漫性致密影，2个病灶CT扫描基本正常。6个病灶骨质膨胀，尤其是棘突。MRI发现6个病灶椎体及附件T1WI、T2WI呈不均匀长短混杂信号影，2个病灶椎体及附件T1WI、T2WI呈弥漫性或大片状明显低信号，1个病灶椎体T1WI、T2WI呈轻微低信号。4个病灶终板见条带状低信号，椎体呈“方框椎”。1个病灶核素骨扫描椎体异常浓聚。结论：脊柱畸形性骨炎的CT及MRI表现具有一定的特征性，分析其影像及临床特点，有助于提高该病的诊断准确率。
Abstract
Objective: The aim of this study was to investigate CT and MRI appearances of spinal osteitis deformans. Methods: The clinical features and images of 6 patients with pathologically proved spinal osteitis deformans after operation or biopsy were retrospectively analyzed. All patients underwent CT plain scan, 4 patients underwent MRI scan and 1 patient underwent radionuclide bone scintigraphy. Results: Solitary lesion was detected in 2 cases, and multiple lesions were found in 4 cases. There was a total of 12 lesions. Nine lesions located in lumbar vertebrae and 3 lesions located in thoracic vertebrae. CT images displayed meshy low density region with thickened bone trabeculae in vertebral body and appendix in 8 lesions, diffuse sclerosis was found in 2 lesions and 2 lesions normal appearance. Six lesions showed bone expansion, especially in the spinous process. MRI images showed mixed areas of hyperintensity and hypointensity on T1WI and T2WI in 6 lesions. Two lesions demonstrated prominent diffuse or patchy low signal intensity on T1WI and T2WI and 1 lesion showed subtle low signal intensity on T1WI and T2WI. Four lesions had a band-like low signal intensity along the endplates with a “picture-frame” spine appearance. Bone scintigraphy showed increased uptake of the vertebral body in 1 lesion. Conclusions: Spinal osteitis deformans has some characteristic appearances on CT and MRI. The combined analysis of imaging and clinical features is helpful to accurate diagnosis of this disease.
关键词
骨炎 /
脊柱疾病 /
体层摄影术 /
X线计算机 /
磁共振成像
Key words
Osteitis /
Spinal diseases /
Tomography, X-ray computed /
Magnetic resonance imaging
中图分类号：
Ｒ681.51
R814.42
Ｒ445.2
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