MRI鉴别布氏杆菌性脊柱炎和早期化脓性脊柱炎的临床价值探析  

Clinical Value of MRI in Identifying Brucellosis Spondylitis and Early Suppurative Spondylitis

作　　者：向旭[1] 张晓亚[1] 尤国庆[2] 吕国义[1] 李建灵[1] XIANG Xu;ZHANG Xiao-ya;YOU Guo-qing;LYU Guo-yi;LI Jian-ling(MRI Room,Nanyang Central Hospital,Nanyang 473009,Henan Province,China;CT Room,Nanyang Central Hospital,Nanyang 473009,Henan Province,China)

机构地区：[1]南阳市中心医院核磁共振室,河南南阳473009 [2]南阳市中心医院CT室,河南南阳473009

出　　处：《中国CT和MRI杂志》2021年第6期160-162,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振成像(MRI)鉴别布氏杆菌性脊柱炎和早期化脓性脊柱炎的临床价值。方法回顾性分析我院2016年1月至2018年9月期间收治经病理证实的32例布氏杆菌性脊柱炎和28例早期化脓性脊柱炎患者的临床病例资料。结果 32例布氏杆菌性脊柱炎共累及椎体69个,其中胸椎22个(31.88%)、腰椎47个(68.21%);28例化脓性脊柱炎共累及椎体63个,其中胸椎14个(22.22%)、腰椎38个(60.32%);32例布氏杆菌性脊柱炎骨质破坏区在T1WI上以低信号为主、T2WI上以不均匀较高信号为主,28例化脓性脊柱炎骨质破坏区在T1WI上以广泛融合的低信号为主、T2WI上以强度高信号或稍高信号多见;32例布氏杆菌性脊柱炎无椎间隙狭窄、椎间盘破坏,28例化脓性脊柱炎多有不同程度的椎间隙狭窄、椎间盘破坏;32例布氏杆菌脊柱炎6例出现脊柱小关节炎、3例出现前纵韧带钙化,28例化脓性脊柱炎均未出现脊柱小关节炎以及韧带钙化改变。结论 MRI对布氏杆菌性脊柱炎和早期化脓性脊柱炎的鉴别诊断具有一定的临床价值。Objective To explore the clinical value of magnetic resonance imaging(MRI)in identifying brucellosis spondylitis and ea rly suppu rative spondylitis.Methods clinical data of 32 brucellosis spondylitis patients and 28 early suppurative spondylitis patients who were confirmed by pathology and were admitted to the hospital from January 2016 to September 2018 were retrospectively analyzed.Results Of the 32 cases with brucellosis spondylitis,69 centrum involved,including 22(31.88%)thoracic vertebrae and 47(68.21%)lumbar vertebrae.Of the 28 cases with suppurative spondylitis,there was63 centrum involved,including 14(22.22%)thora cic ve rtebrae and 38(60.32%)lumbar vertebrae.The bone destruction a reas of 32 cases with brucellosis spondylitis were mainly on the low signal on TIWI,mainly on the uneven high signal on T2 WI.The bone destruction areas of 28 cases with suppurative spondylitis were a mainly low signal of extensive fusion on T1 WI,mainly on high-intensity signal or slightly higher signal on T2 WI.In the 32 cases with brucellosis spondylitis,there was no intervertebral space stenosis or intervertebral disc destruction.In the 28 cases with suppurative spondylitis,there were intervertebral space stenosis and intervertebral disc destruction of different degrees.In the32 cases with brucellosis spondylitis,there were 6 cases with spinal arthritis,3 cases with anterior longitudinal ligament calcification.In the 28 cases with suppurative spondylitis,there was no spinal a rthritis or ligament calcification changes.Conclusion MRI is of certain clinical value in the differential diagnosis of brucellosis spondylitis and ea rly suppu rative spondylitis.

关 键 词：磁共振成像 布氏杆菌性脊柱炎 化脓性脊柱炎 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.51[医药卫生—诊断学]