目的观察胸腰椎结核的MRI多 序列特征，分析其临床诊断价值。方 法 利用MRI对30例胸腰椎结核患者进行 多序列扫描。结果 2个椎体受累18例， 占60.0%，而2个椎体以上受累12例，占 40.0%，最多受累椎体数目为5个，共累 计椎体78个，其中胸椎18个，胸腰椎22 个，腰椎32个，腰骶椎6个。78个破坏椎 体T1WI大多呈低信号、少部分呈等、低混 杂信号，T2WI脂肪抑制序列呈均匀高信 号，T2WI上骨质破坏区多呈不均匀较高信 号，炎性水肿区T1WI呈片状低信号。25例 患者受累椎体邻近55个椎间盘破坏、间隙 变窄或消失，5例间隙未改变。受累椎间 盘T1WI呈低信号，35个受累椎间盘T2WI呈 不均匀混杂信号，20个受累椎间盘T2WI呈 均匀高信号。30例患者椎旁均可见寒性 脓肿，寒性肿胀多跨越2个以上椎体，在 T1WI呈低信号22例，等信号8例，T2WI呈 混杂高信号8例，均匀高信号20例，2例低 信号。15例患者30个受累椎体水平出现椎 管狭窄，其中4例在脊髓受压变形T2WI呈 现异常高信号。结论 MRI能够显示胸腰椎 结核椎体破坏、椎间盘的形态、信号变 化、寒性脓肿及椎管受累程度等多种早期 影像学特征，同时多平面成像可以完整显 示受累椎体的个数和病变范围，且同时显 示脊椎病变在硬膜内、外及椎体脓肿对脊 髓的受压程度。

Objective To observe the characteristics of MRI multiple sequences of thoracic and lumbar tuberculosis and analyze their clinical diagnostic value. Methods A total of 30 cases of thoracic and lumbar tuberculosis patients were scanned by MRI. Results There were 2 vertebral bodies with involvement in 18 cases, accounting for 60.0% and more than 2 vertebral bodies with involvement in 12 cases, accounting for 40.0%. The largest number of vertebral bodies with involvement was 5, a total of 78 vertebral bodies were involved, including 18 thoracic vertebrae, 22 thoracic and lumbar spines, 32 lumbar vertebrae and 6 lumbosacral vertebrae. 78 destructed vertebrae showed more low signal, few low, equal mixed signal on T1WI. T2WI fat suppression sequences showed homogeneous high signal. Area of bone destruction showed inhomogeneous high signal on T2WI, inflammatory edema showed patchy low signal on T1WI. Involved vertebrae of 25 cases were close to 55 intervertebral discs damage, narrowing or disappearance, the intervertebral space was not changed in 5 cases. The involved intervertebral disc showed low signal on T1WI, 35 involved intervertebral discs showed heterogeneous mixed signals on T2WI, and 20 involved intervertebral discs showed inhomogeneous high signal on T2WI. There was cold abscess close to vertebral body in 30 cases, cold abscess mostly occurred in more than 2 vertebral bodies, showing low signal on T1WI in 22 cases, equal signals in 8 cases, showing mixed high signal on T2WI in 8 cases, homogeneous high signal in 20 cases, low signal in 2 cases. In 15 cases, there was spinal stenosis in 30 affected vertebral bodies, of which 4 cases of deformed spinal cords showed abnormal high signal on T2WI. Conclusion MRI can display vertebral body damage, shape and signal changes of intervertebral disc, cold abscess, spinal involvement and other early imaging features of thoracic and lumbar tuberculosis. Multiplanar imaging can show the complete involvement of vertebral body and the number of lesions, and also shows the internal and external spinal epidural lesions and compression of vertebral abscess on the spinal cord.