| 感染性椎间盘炎的MRI诊断及临床综合治疗 |
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Received:October 28, 2004
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| 期刊信息：《中国骨伤》2005年18卷，第10期，第588-590页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨感染性椎间盘炎的MRI诊断价值及临床综合治疗。
方法:搜集经MRI诊断,临床或手术病理证实的感染性椎间盘炎20例进行回顾性分析。全部病例均采用美国GE signa contruo0.5T超导MR扫描仪检查,常规SE序列,矢状位,T1WI,T2WI。8例采用钆喷酸葡甲胺(Gd-DTPA)增强扫描。20例感染性椎间盘炎患者中有25个椎间盘感染,其中单纯腰椎间盘感染17例,腰骶椎椎间盘同时感染3例。将20例患者随机分为治疗组和对照组,治疗组急性期采用大剂量抗生素冲击疗法并内服活血化瘀,消炎补肾,通络止痛等中药;慢性期采用中药熏洗,超短波理疗及远红外线热疗等。对照组急性期采用常规剂量抗生素治疗,慢性期采用理疗等方法。
结果:①MRI结果急性期14例,MRI表现为病变椎间盘,边缘模糊,呈略长T1、长T2信号。部分椎间盘破坏或碎裂,相邻椎体及软组织受累亦呈略长T1、T2信号。慢性期6例,MRI表现为病变椎间盘变薄或消失,呈混杂长T1,混杂长T2信号,周围组织不同程度受累。②治疗组结果急性期7例,保守治疗痊愈6例,手术治疗痊愈1例。慢性期3例,痊愈2例,1例遗留慢性腰痛症状。③对照组结果急性期7例,保守治疗痊愈3例,手术治疗痊愈4例。慢性期3例,痊愈1例,无效2例(改用综合治疗方法后痊愈)。
结论:MRI对感染性椎间盘炎的诊断及监测治疗效果有重要价值;对感染性椎间盘炎临床应根据分期采用综合治疗。 |
| [关键词]:感染性椎间盘炎 MRI诊断 中草药 抗生素 |
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| MRI diagnosis and clinical comprehensive treatment for infected intervertebral disc |
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Abstract:
Objective: To explore MRI diagnostic value and clinical comprehensive treatment for infected intervertebral disc.
Methods:Twenty patients of infected intervertebral disc finally diagnosed by MRI and operative pathology were retrospective analyzed.All the patients were scanned with regular SE sequence at sagittal plane,in T1WI and T2WI series of MRI （GE signa contruo 0.5 T superconduction MRI computer）,of them,scanning was enhanced with Gd-DTPA in 8 cases.25 intervertebral discs were infected in the 20 patients （17 cases had infection of simple lumbar intervertebral discs and 3 cases had co-infection of lumbosacral vertebrae）.All the 20 patients were randomly divided into treatment group and control group In the treatment group,the 7 acute cases were treated with large dose of antibiotic and peroral traditional Chinese medicine and the 3 chronic cases were treated by fumigation and lotion with traditional Chinese herbs and physical therapy.In the control group,7 acute cases were treated with routine dosage antibiotic and the 3 chronic cases were treated with physical methods.
Results:（1） MRI Results In the 14 acute cases,the border of intervertebral discs were unclear on MR imaging,which appeared slight long T1 and long T2 signal.A few intervertebral discs were destructed or broken.The adjacent vertebral body and soft tissue were involved,their signals were slight long T1、long T2 as well.In the 6 chronic cases,intervertebral discs were thinner or disappeared on MR imaging,which exhibited as complex long T1 and T2 signal.Peripheral tissues were involved at different degrees.（2） In the treatment group,7 acute patients were completely cured （6 cases with conservative treatment and 1 case with surgery）;of 3 chronic patients,2 cases were completely cured,1 case still remained lumbago.（3） In the control group,7 acute patients were completely cured （3 cases with conservative treatment and 4 cases with surgery）;of 3 chronic patients,1 case was completely cured,2 cases were ineffective after comprehensive treatment).
Conclusion:MRI is valuable for the diagnosis and clinical evaluation of infected intervertebral disc.Comprehensive treatment should be applied to infected intervertebral disc according to different pathological stages |
| KEYWORDS:Infecting vertebra disc MRI diagnosis Drugs,Chinese herbal Antibiotic |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 郭炳伦.感染性椎间盘炎的MRI诊断及临床综合治疗[J].中国骨伤,2005,18(10):588~590 |
| 英文格式: | GUO Bing-lun.MRI diagnosis and clinical comprehensive treatment for infected intervertebral disc[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(10):588~590 |
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