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目的探讨单椎体结核的诊断及鉴别诊断特点。方法回顾分析了13例单椎体结核患者临床特点,并与96例多椎体结核及7例伴椎间盘破坏的单椎体结核患者进行对比。结果与多椎体结核相比,单椎体结核病史更短P<0.01,血沉值更低P<0.05。与伴椎间盘破坏的单椎体结核相比,单椎体结核X线硬化更多见,压缩更少见。CT及MRI显示单椎体结核椎弓正常。MRI显示结核病变在T1加权为低信号,T2加权为高信号;脓肿在T2加权为高信号,而强化后则为低信号。结论单椎体结核为脊柱结核的早期形式;脊柱结核后椎间盘是否破坏与病程有关;椎弓情况及脓肿有助于单椎体结核与恶性肿瘤的鉴别。
Objective To investigate the diagnosis and differential diagnosis of single vertebral tuberculosis. Methods The clinical features of 13 patients with single vertebral tuberculosis were retrospectively analyzed and compared with 96 cases of multi-vertebral tuberculosis and 7 cases of single-vertebral tuberculosis with disrupted disc. Results Compared with multi-vertebral tuberculosis, the history of single-vertebral tuberculosis was shorter (P <0.01) and erythrocyte sedimentation rate was lower (P <0.05). Compared with single vertebral tuberculosis with disrupted intervertebral disc, X-ray sclerosis of single vertebral tuberculosis is more common and compression is less common. CT and MRI showed normal single vertebral tuberculosis. MRI showed that tuberculosis lesions were low in T1 weighted and T2 weighted high; abscess was high in T2 weighted and low in enhanced. Conclusions Single vertebral tuberculosis is the early form of spinal tuberculosis. Whether spinal disc is destroyed after spinal tuberculosis is related to the course of disease. The condition of vertebral arch and abscess are helpful to distinguish single tuberculosis from malignant tumor.