MRI对颈椎布鲁杆菌病性脊椎炎的治疗价值评价  

Evaluation on therapeutic value of MRI for cervical Brucella spondylitis

作　　者：孟宪勇[1] 杨新明[1] 胡长波[1] 康聪[1] 张振梁[1] 郝运兵 

机构地区：[1]河北北方学院附属第一医院骨外科,河北张家口075000

出　　处：《实用放射学杂志》2017年第3期429-433,共5页Journal of Practical Radiology

基　　金：河北省医学重点学科跟踪项目（GL2014069）.

摘　　要：目的 探讨以MRI为主的影像分型对颈椎布鲁杆菌病性脊椎炎（BS）的诊断意义及治疗方案评价.方法 将本院诊治39例颈椎BS患者的影像资料,依据MRI分型进行非手术、微创术与切开直视手术治疗;通过影像分析一致性检验、影像学评分、临床疗效评价分析相关性.采用SPSS15.0统计软件包进行分析.结果 本组39例治疗前行MRI检查,6个月37例复查;12个月33例复查.影像分析一致性检验Kappa值均〉0.75.颈椎BS的MRI影像学具有特征性表现,依据术前MRI影像分型治疗结果：（1）药物治疗14例（A组）;（2）微创治疗7例（B组）;（3）病灶清除植骨术18例（C组）;（4）临床疗效显示各组12个月治愈率与前一个时间点比较差异有统计学意义（P〈0.05）,且在6个月时间点C组治愈率明显优于其他2组.在12个月时间点3组治愈率比较,以及C组各方法治愈率比较差异无统计学意义（P〉0.05）.结论 颈椎BS的MRI影像学分型对临床保守、微创和手术治疗策略的制订具有重要价值及指导意义.Objective To discuss MRI diagnositic value and evaluation of the treatment of cervical Brucella spondylitis（BS）.Meth-ods MRI data of 39 cases with cervical BS in our hospital were collected.Non-operative treatment,minimal invasive surgery and the open surgery were selected according to the MRI manifestations.The correlation was analyzed by consistensy check,imaging score and clinical effect evaluation.The data were analyzed by SPSS15.0.Results 39 cases of patients were examined by MRI before the treatment.37 cases were reviewed after 6 months treatment and 33 cases were reviewed after 12 months treatment.All of the Kappa values were more than 0.75 by imaging consistency check.MRI of cervical BS possessed characteristic expressions.The treatment effect according to MRI classification before the treatment：（1）drug therapy was performed in 14 cases （Group A）;（2）minimal inva-sive surgery was performed in 7 cases （Group B）;（3）focus clearance and bone graft were performed in 18 cases （Group C）;（4）the clinical effects showed the healing rate in every group at different time point was different and the difference had statistical signifi-cance（P〈0.05）.The healing rate in Group C was higher than it in other group at 6 months after treatment.There was no significant difference among 3 groups or among different method group（Group C1,C2 and C3）in Group C at 12 months after treatment（P〉0.05）. Conclusion MRI classification for cervical BS has important value and guiding significance in the selection of clinical conservative treatment,minimal invasive surgery or the open surgery.

关 键 词：颈椎 布鲁杆菌病性脊椎炎 磁共振成像 

分 类 号：R681.51[医药卫生—骨科学] R445.2[医药卫生—外科学]