布鲁菌性脊柱炎与脊柱结核临床影像学表现的对比  

Brucellar and tuberculous spondyliUs： a comparative study of their imaging features

作　　者：楚戈[1] 张宏其[3] 黄佳[4] 胡炜[2] 王昱翔[3] 卡哈尔·艾肯木[1] 

机构地区：[1]新疆医科大学附属中医医院脊柱一科,乌鲁木齐830000 [2]新疆医科大学附属中医医院脊柱二科,乌鲁木齐830000 [3]中南大学湘雅医院脊柱外科 [4]中南大学湘雅二医院ICU

出　　处：《中华传染病杂志》2015年第6期335-338,共4页Chinese Journal of Infectious Diseases

摘　　要：目的分析与探讨布鲁菌性脊柱炎与脊柱结核不同的临床影像学特征，提高对布鲁菌性脊柱炎的影像学诊断水平。方法回顾性分析2011年1月至2013年12月，新疆医科大学附属中医医院收治的46例布鲁菌性脊柱炎患者的X线片、CT、MRI影像学资料，与确诊的40例脊柱结核患者的影像学资料进行对比分析。结果布鲁菌性脊柱炎病灶分布于腰椎，其中以L4患病率最高，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，新生骨组织中有新破坏灶形成，椎间盘破坏轻，关节面增生硬化，相邻骨密度增高，少或无椎旁脓肿形成。结核病灶分布于胸腰段，以椎体和椎间盘骨破坏为主，并有死骨形成，椎旁脓肿和骨质疏松变化较常见。结论布鲁菌性脊柱炎和脊柱结核临床影像学特征性表现有助两者的鉴别诊断。Objective To analyze and discuss the different characteristics of clinical imaging of Brucellar and tuberculous spondylitis, and to improve the diagnostic performance of the image of Brucellar spondylitis. Methods A retrospective analysis at Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University was conducted from January 2011 to December 2013. X-ray, computer tomography （CT） and magnetic resonance imaging （MRI） data of 46 cases of Brucellar spondylitis and 40 cases of tuberculous spondylitis were compared. Results The lumbar spine, especially L4, was usually involved in brucellosis, characterized with multiple small lesions mostly confined to the edge of vertebral body and surrounded by the hyperplasia and sclerosis. New damaged foci were formed in the new bone tissue and intervertebral discs destruction was slight with hyperplasia and sclerosis of articular surface. Few or no paravertebral abscesses were seen. In contrast, thoracic and lumbar spines were more usually affected in tuberculosis featured with destruction of vertebra and intervertebral discs. There could be dead bone formation. Paravertebral abscesses and osteoporosis were frequent. Conclusion The different imaging characteristics of Brucellar and tuberculous spondylitis could favor the differential diagnosis.

关 键 词：布鲁菌性脊柱炎 结核 脊柱 影像学 研究 

分 类 号：R516.7[医药卫生—内科学] R529.2[医药卫生—临床医学]