【摘要】目的  探讨CT和MRI在脊柱结核中的诊断价值。材料和方法  回顾性分析经手术病理证实、穿刺活检和临床抗结核治疗有效的45例患者的临床及影像资料，包括CT22例，MRI23例，其中15例病人进行了CT、MRI两项检查，2例进行了增强扫描。结果  45例脊柱结核病变中颈椎2例、胸椎11例、胸腰椎6例、腰椎18、腰骶椎5例和骶椎3例。CT能较好的显示骨质破坏、增生硬化、死骨、椎旁脓肿及钙化等变化；MRI能较好的显示骨髓水肿、椎旁脓肿、椎间盘、椎管及硬膜囊等改变。结论  CT和MRI对脊柱结核均具有较高的诊断价值。CT在显示骨质破坏和钙化等方面具有优势，MRI在显示早期病变、病变范围、椎管及脊髓侵犯等方面具有优势，两种技术综合使用有助于脊柱结核的诊断与鉴别诊断。

Objective To discuss the diagnosis value of CT and MRI in spinal tuberculosis. Materials and Methods Retrospective analysis of 45 cases (22 cases of CT,23 cases of MRI(15 cases of both), 2 cases of enhancement scan)confirmed by the surgical operation pathology, needle biopsy and antituberculosis therapy imaging of CT and MRI material of spine tuberculosis. Results 45 cases of spinal tuberculosis, cervical vertebra lesion in 2 case, thoracic vertebra lesion in 11 cases, thoracolumbar spine lesion in 16, lumbar vertebra lesion in 18 cases, lumbosacral vertebrae in 5 cases, sacral vertebrae in 3 cases were found. The CT could show the bone destruction, the bone increase osteoslerosis, sequestrum formation, swelling paraspinal soft tissue and calcification, etc. MRI could show bone marrow edema, paravertebral abscess formation, changes of intervertebral disc, spinal canal and the dural sac. Conclusion CT and MRI in the diagnosis of spinal tuberculosis has obvious value. CT has an advantage over showing sequestrum and calcification. MRI has an advantage over showing the early tuberculous, confirm the range of lesions, epidural and spinal cord invasion, etc. Synthesizing characteristics of the both will help to diagnosis, differential diagnosis of spinal tuberculosis.