布氏杆菌性脊柱炎临床影像学及病理学表现  

Imaging Manifestations and Pathological Characters of the Brucellar Spondylitis

作　　者：杨新明[1] 石蔚[2] 杜雅坤[3] 孟宪勇[1] 邹宇炜[1] 

机构地区：[1]河北北方学院附属第一医院骨科,河北张家口075000 [2]河北北方学院附属第一医院儿科,河北张家口075000 [3]河北省儿童医院

出　　处：《实用放射学杂志》2008年第4期522-525,共4页Journal of Practical Radiology

摘　　要：目的探讨布氏杆菌性脊椎炎临床影像学及病理学特点,以便提高对该病的鉴别诊断水平。方法本组16例经手术病理证实为布氏杆菌性脊椎炎的X线、CT、MR影像学及病理学资料回顾性分析,并与已确诊的脊椎结核影像学资料作比较。结果本组病灶均位于腰椎,以L4发病率最高(87.50%)。骨破坏灶小而多发,多局限于椎体边缘,病灶周围明显增生硬化,新生骨组织中又有新破坏灶形成,但无死骨形成,椎间盘破坏轻,可伴有椎体小关节损害,少有或无椎旁脓肿形成。脊椎结核以椎体和椎间盘破坏为主,伴有死骨形成,椎旁脓肿和骨质疏松常见。结论布氏杆菌性脊椎炎临床影像学及病理学具有特征性表现,与脊椎结核可以作出鉴别诊断。Objective To study the features of the clinical radiology and pathology of burcellar spondylitis so that to improve the differential diagnosis level of this disease. Methods The imaging features of brucellar spondylitis proved by operation and pathology were retro- spectively analysed comparatively with that of spinal tuberculosis. Results The lesions were all localized at lumbar spine and most of them was L4 （ 87.50% ）. The imaging included involvement of edge portion of vetebral body, multiple and small bone destruction with osteosclerotic margins,having new bony destruction within osteosclerotic area,absence of sequester within lesion,no paraspinal abscess and involvement of intervertebral joints,intervertebral disc destruction slightly. While,in spinal tuberculosis, the intervertebral body and disc were mainly involved in company with sequesters and paraspinal abscess,and osteoporosis was mostly seen. Conclusion The brucellar spondylitis and spinal tu- berculosis demonstrate their own special clinical imaging and pathological features,the differentiating diagnosis can be made between them.

关 键 词：布鲁氏菌病 脊椎炎 X线摄影 体层摄影术 X线计算机 磁共振成像 病理学 

分 类 号：R681.51[医药卫生—骨科学] R814.42[医药卫生—外科学]