目的 探讨分析脊柱结核、转移 瘤的MRI影像学特征及鉴别诊断价值。方 法 选取我院确诊的49例脊柱结核(结核 组)、69例脊柱转移瘤患者(转移瘤组)， 收治时间2013年1月-2017年1月，对两组 患者的MRI影像学资料进行分析，以病理 学检测结果作为判定金标准，分析MRI检 查在鉴别诊断脊柱结核、转移瘤中的临 床价值。结果 结核组和转移瘤组的病灶 位于椎体部位分布情况、累积椎间盘发 生率、病灶形态的影像学形态、椎旁肿块 信号强化发生率、椎体内部T2加权像表 现、软组织病变信号表现比较，差异均具 有统计学意义(P<0.05)；结核组和转移瘤 组的病灶单发或多发情况、骨质破坏类 型、椎体轮廓压缩变形情况比较，差异均 不具有统计学意义(P>0.05)；以病理学结 果作为判定金标准，MRI检查诊断脊柱结 核与脊柱转移瘤的灵敏度为91.84%、特异 度为86.96%、漏诊率为8.16%、误诊率为 13.04%、阳性预测值为83.33%、阴性预测 值为93.75%。结论 MRI对于脊柱结核、转 移瘤具有较高的鉴别诊断价值。

Objective To investigate the value of MRI in the diagnosis and differential diagnosis of spinal tuberculosis and metastatic tumors. Methods A total of 49 cases of spinal tuberculosis diagnosed in our hospital (tuberculosis group), 69 cases of patients with spinal metastatic tumors (metastasis group), from January 2013 to January 2017, MRI images of two groups were retrospectively analyzed, according to the pathological results as the gold standard to determine the detection, calculation of MRI examination in the differential diagnosis of spinal tuberculosis the clinical value of tumor metastasis. Results The lesions of tuberculosis group and metastasis group located in the vertebral body distribution, the cumulative incidence of intervertebral disc lesions, imaging morphology, paraspinal mass signal enhancement incidence of vertebral bodies and T2 weighted images showed soft tissue lesions, the signal, the differences were statistically significant (P<0.05), single lesion group and metastasis of tuberculosis tumor group or multiple cases, the type of bone destruction, vertebral compression deformation contour comparison, the difference was not statistically significant (P>0.05), to determine the pathological results as the gold standard, the sensitivity of MRI in diagnosis of spinal tuberculosis and spinal metastases was 91.84%, the specificity was 86.96%, the misdiagnosis rate was 8.16%, misdiagnosis the rate was 13.04%, the positive predictive value was 83.33%, the negative predictive value was 93.75%. Conclusion MRI for spinal tuberculosis, metastatic tumors have a high differential diagnosis.