布鲁杆菌病性脊椎炎的影像学分型及临床意义  

Brucellosis spondylitis imaging classification and clinical significance

作　　者：杨新明[1] 王耀一[1] 石蔚[1] 章鹏[1] 阎斌 张培楠[1] 高永革 吴伟[1] 崔书君[1] 

机构地区：[1]河北北方学院附属第一医院,河北张家口075000 [2]河北省崇礼县高家营中心卫生院 [3]河北张家口市传染病医院

出　　处：《中国骨与关节外科》2014年第2期122-127,共6页Chinese Journal of Bone and Joint Surgery

基　　金：2013年河北省医学重点学科跟踪项目(GL201321);2013年河北省省级重大医学科研课题(zd2013049);张家口市2010年科学技术与发展指令计划资助项目(1012010D-1)

摘　　要：背景：布鲁杆菌病性脊椎炎的发病率正逐渐升高，而其影像学分型有利于该病的标准化治疗及疗效评价。 目的：探讨布鲁杆菌病性脊椎炎的影像学分型及其临床意义。 方法：回顾分析2008年1月至2012年7月经临床及实验室检查确诊为布鲁杆菌病性脊椎炎的89例患者的影像学资料，依据X线、CT及MR影像学表现对患者进行分型。 结果：布鲁杆菌病性脊椎炎的影像学分Ⅰ-Ⅴ型。Ⅰ型：椎体炎型，Ⅱ型：椎间盘炎型，Ⅲ型：骨膜炎型，Ⅳ型：椎旁脓肿或腰大肌脓肿型，Ⅴ型：脊髓神经型。两型以上为复合型。本组46例为复合型（51.69%），其中Ⅴ型伴有其他4种类型最多（45例）；43例为单纯型（48.31%），其中Ⅰ型20例、Ⅱ型9例、Ⅲ型4例、Ⅳ型6例、Ⅴ型4例。31例通过非手术治愈，58例采用手术治疗，其中52例行病灶清除术、6例行经皮微创术治疗。本组89例均随访1年，痊愈83例，好转6例，愈后无复发。 结论：布鲁杆菌病性脊椎炎影像学分型对临床诊治策略的制定具有参考价值及指导意义。Background：The incidence of brucellosis spondylitis has been gradually increased. Its radiological image typing can pro-vide help for standardized treatment and evaluation of clinical outcomes. Objective：To explore imaging classification of brucellosis spondylitis and its clinical significance. Methods：Imaging data of 89 patients identified by clinical and laboratory diagnosis as brucellosis spondylitis between Janu-ary 2008 and July 2012 were analyzed retrospectively. The radiological classification of the cases was based on X-ray, CT and magnetic resonance （MR） imaging. Results：Brucellosis spondylitis radiological images were categorized into five types.Ⅰtype：vertebral inflammatory type,Ⅱtype：discitis type,Ⅲtype：periostitis type,Ⅳtype：paraspinal abscess or psoas abscess type, andⅤtype：spinal neuro-nal type. The coexistence of two or more types was classified into mixed type. There were 46 cases （51.69%） with two or more type lesions and 43 cases （48.31%） with single type lesion. Of the single type lesion, there were 20 cases ofⅠtype, 9 cases ofⅡtype, 4 cases ofⅢtype, 6 cases ofⅣtype and 4 cases ofⅤtype. There were 31 cases with non-surgical treat-ment, 52 with debridement and 6 with percutaneous minimally invasive surgery. After one-year follow-up, 83 cases were cured and 6 cases improved. No recurrence occurred. Conclusions：The imaging classification of Brucellosis spondylitis can provide help for clinical diagnosis and treatment.

关 键 词：布鲁杆菌病 脊椎炎 X线摄影 体层摄影术 X线计算机 磁共振成像 影像学分型 临床治疗 

分 类 号：R516.7[医药卫生—内科学]