脊柱结核的诊断——计算机断层扫描研究

Sayar Ahmad Taley, K. Ganaie, Mohammad Saleem Dar
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摘要

结核病是一种主要由结核分枝杆菌引起的传染病,其发病率在全球范围内呈上升趋势。目的:这是一项以医院为基础的回顾性研究,旨在确定CT在建立脊柱结核明确诊断中的作用。材料与方法:从医院数字数据库中检索患者资料。在120例患者中,有14例患者纳入本研究。记录患者的年龄、性别、症状和体征。CT轴位、冠状位、矢状位扫描。由放射科专家检查CT轴位、冠状位和矢状位切片。结果:在本研究期间,120例成人脊柱结核患者中发现14例(11.4%)。我们病例的平均年龄(±SD)为46.5(±22.0)岁。14人中男性8人,女性6人,男女比例为1.4。平均持续时间为1.25年。最常见的特征是腰痛,在93%的病例中可见,其次是脊柱节段性僵硬(50%)。这些病例的诊断基于病史、体格检查、椎体x线片、CT扫描和对药物的反应。在椎体影像学上,大多数病例可见腰椎病变(57%),其次是背侧病变(36%)和颈椎病变(7%)。除2例髓质受压外,其余病例预后良好。结论:近年来,脊柱结核的发病率在发达国家和发展中国家都有所增加,由于在这种情况下不能立即进行组织病理学检查,因此很难诊断。在CT上出现背痛并伴有颈椎病的主要放射学征象可用于诊断此病
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Diagnosis of Spinal Tuberculosis -A Computed Tomography Study
Introduction: Tuberculosis is an infectious disease, mainly caused by Mycobacterium tuberculosis and its incidence have increased across the globe. Objective: This was a hospital based retrospective study and was used to determine the role of CT in establishing the definitive diagnosis of spinal TB. Material and Methods: The patient data was retrieved from the digital database of the hospital. Out of 120 patients, 14 patients were included in this study. Patients age, sex, symptoms and signs were noted down. CT scan with axial, coronal and sagittal sections were studied. Axial, coronal and sagittal sections of CT were reviewed by an expert radiologist. Results: Fourteen (11.4%) adults with spinal tuberculosis were found among 120 patients during this study period. The mean age (± SD) in our cases was 46.5 (± 22.0) years. Out of 14, 8 were males and 6 were females, with male: female ratio of 1.4. The mean duration was 1.25 years. The most common feature was rachialgia which was seen in 93% of cases, followed by segmental spinal stiffness (50%). The diagnosis in these cases was based on history, physical examination, vertebral radiographs, CT scan and response the medications. On vertebral imaging, lumbar lesions (57%) were seen in most of the cases, followed by dorsal (36%) and cervical (7%) involvement. The prognosis was good in all these cases except in two patients with medullary compression. Conclusion: In the recent years, the incidence of spinal TB has increased in both the developed and developing nations and is difficult to diagnose as histopathology is not done straight away in such cases. The presence of back pain associated with major radiological signs of spondylosis on CT can be used to diagnose this condition
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