【摘要】 目的 探讨脊柱结核与化脓性脊柱炎CT征象差别。方法 回顾性分析32例脊柱结核与30例化脓性脊柱炎患者的CT表现，对不同征象进行记录和统计学分析。结果 32例脊柱结核累及71个脊椎，30例化脓性脊柱炎累及59个脊椎。胸椎受累脊柱结核发生率60.56%(43/71),高于化脓性脊柱炎(25.42%,15/59),P<0.05。腰椎受累脊柱结核发生率33.80%(24/71),低于化脓性脊柱炎(61.02%,36/59),P<0.05。虫蚀型骨质破坏脊柱结核发生率9.90%(7/71),低于化脓性脊柱炎(44.07%,26/59),P<0.05。碎片型骨质破坏脊柱结核发生率19.72%(14/71),高于化脓性脊柱炎(3.39%,2/59),P<0.05。广泛骨硬化脊柱结核出现率52.11%(37/71),高于化脓性脊柱炎(22.03%, 13/59),P<0.05。矢状位上受累椎体高度小于正常椎体高度1/2者脊柱结核发生率16.90%(12/71),低于化脓性脊柱炎(62.71%,37/59),P<0.05。病灶内钙质样高密度影脊柱结核发生率50.70%(36/71),高于化脓性脊柱炎(20.34%,12/59),P<0.05。附件受累脊柱结核发生率25.35%(18/71),高于化脓性脊柱炎(8.47%,5/59),P<0.05。椎旁异常软组织伴钙化脊柱结核发生率60.00%(18/30),高于化脓性脊柱炎(20.00%,5/25),P<0.05。结论 脊柱结核与化脓性脊柱炎二者的CT征象具有一定特征，结合临床特点可及时作出鉴别诊断。更多还原

【Abstract】 Objective This study was to investigate the computed tomography(CT) features differentiating tuberculous spondylitis from pyogenic spondylitis.Methods The CT features in 32 patients with tuberculous spondylitis and 30 patients with pyogenic spondylitis were retrospectively reviewed, and statistically analyzed. Results In 32 cases of tuberculous spondylitis, 71 vertebra were involved. In 30 cases of pyogenic spondylitis, 59 vertebra were involved.The incidence of thoracic vertebra involvement in tuberculous spondylitis was 60.56%(43/71),which was higher than that in pyogenic spondylitis(25.42%,15/59)(P<0.05). The incidence of lumbar vertebra involvement in tuberculous spondylitis was 33.80%(24/71),which was lower than that in pyogenic spondylitis(61.02%,36/59)(P<0.05). The incidence of the worm-eaten type of bone destruction in tuberculous spondylitis was 9.90%(7/71),which was lower than that in pyogenic spondylitis(44.07%,26/59)(P<0.05).The incidence of the fragmentary type of bone destruction in tuberculous spondylitis was 19.72%(14/71),which was higher than that of in pyogenic spondylitis(3.39%,2/59)(P<0.05). The incidence of large osteosclerosis in tuberculous spondylitis was 52.11%(37/71),which was higher than that in pyogenic sp-ondylitis(22.03%, 13/59),(P<0.05). The incidence of the involved vertebral height on sagital CT scan( less than the 1/2 of the normal vertebral height) in tuberculous spondylitis was 16.9%(12/71),which was lower than that in pyogenic spondylits(62.71%,37/59)(P<0.05). The incidence of patchy high density shadow in tuberculous spondylitis was 50.7%(36/71),which was higher than that in pyoge-nic spondylitis(20.34%,12/59)(P<0.05.)The incidence of the involvement of the appendages in tuberculous spondylitis was 25.35%(18/71),which was higher than that in pyogenic spondylitis(8.47%,5/59)(P<0.05). The incidence of paravertebral abnormal soft tissue with calcification in tuberculous spondylitis was 60.00%(18/30),which was higher than that in pyogenic spondylitis(20.00%,5/25)(P<0.05).Conclusion Tuberculous spondylitis and pyogenic spondylitis have some characteristic imaging features, combined with the clinical signs differentiation diagnosis can be made each other.更多还原