脊椎結核病佔1%於結核病之病患,並且佔50~60%於骨骼結核病,其初期診斷較困難,因臨床上不夠機警、症狀變化無窮,並且初期一般傳統放射線影像診斷也不易。其最常侵犯的部份為胸和腰椎,少見於頸椎首和骶骨。新光吳火獅紀念醫院由1993年5月至2003年8月共收集了21疑似脊椎結核病,年齡由11歲至76歲,平均年齡為43.5歲,11男10女,這些病患都接受常規的放射線攝影,其中7例接受電腦斷層攝影,19例接受核磁共振造影,1例接受脊髓攝影術和脊髓電腦斷層攝影,並且經過開刀和病理組織診斷為脊椎結核病。因此,我們將其放射線上及核磁共振造影影像之變化提出討論,並提供給大家參考、指教。
In the recent years, the incidence of tuberculosis (TB) has increased, especially in the developing countries. TB becomes more likely to be extrapulmonary disease. The spine is the most common location of the skeletal involvement. Conventional radiography remains to the cornerstone for diagnosis, but never modalities. Three-dimensional imaging becomes increasingly valuable in accurate diagnosis. Twenty-one patients of tuberculosis of spine (TB spine) were studied. In some case, the complicated anatomy and the extent of the lesion could not be clearly depicted on conventional radiography, thus computed tomography and magnetic resonance imaging were helpful. The clinical course diagnosis was discussed.