目的 探究不同影像学方法在诊 断脊柱结核中的应用价值。方法 回顾性 分析2014年6月-2017年6月间收治的75例 脊柱结核患者临床资料，所有患者均行 磁共振成像(MRI)、电子计算机断层扫描 (CT)检查。比较2种影像学检查图像质 量及结核阳性征象检出率(椎旁脓肿、 椎管狭窄、钙化情况、骨质坏死)。结 果 ①MRI和CT图像质量良好率对比差异 无统计学意义(P>0.05)；②MRI和CT比 较，骨质破坏检出率差异均无统计学意义 (P>0.05)，MRI较CT椎旁脓肿、椎管狭窄 检出率高(P<0.05)，而CT较MRI骨质坏死 检出率高(P<0.05)；③CT显示多数患者存 在不同程度的椎体骨质破坏，可表现为洞 穴状、虫蚀样、碎裂型改变，钙化为砂砾 状、斑点状或环状等；MRI中T1多数呈现 低信号，少数呈现等、低混杂信号；T2 多呈现均匀高信号或混杂信号。结论 CT 和MRI均是有效诊断脊柱结核的影像学检 查，但MRI在椎旁脓肿及椎管狭窄检出中 更有优势，CT在检出死骨中更有优势。

Objective To explore the application values of different imaging methods in the diagnosis of spinal tuberculosis. Methods The clinical data of 75 cases of patients with spinal tuberculosis treated in our hospital from June 2014 to June 2017 were retrospectively analyzed. All patients were given magnetic resonance imaging (MRL) and computerized tomography (CT). The image quality and detection rate of tuberculosis positive signs (bone destruction, paravertebral abscess, spinal canal stenosis, calcification, osteonecrosis) were compared between the 2 imaging methods. Results ①There was no difference in the image quality of MRI or of CT (P>0.05). ② There was no significant difference in the detection rate of bone destruction between MRI and CT (P>0.05), and the detection rates of paravertebral abscess and calcification were higher in the MRI compared with those in the CT (P<0.05) while the detection rate of osteonecrosis was lower (P<0.05). ③CT showed that most patients were with varying degrees of vertebral bone destruction, which could be characterized by cave-like, worm-eaten, fragmented changes. Calcification was with gravel, speckled or ring shape. In MRI, most of the T1 showed low signal, and a few presented equal and low hybrid signals, and T2 mostly showed uniform high signal or mixed signal. Conclusion Both CT and MRI are effective imaging methods for the diagnosis of spinal tuberculosis, but MRI is more advantageous in the detection of paraspinal abscesses and spinal stenosis, and CT is more advantageous in the detection of dead bone.