布鲁菌性脊柱炎影像学特征与临床分期的相关性  

Correlation between imaging features and clinical stages of brucellosis spondylitis

作　　者：伍彦辉 郭立杰[2] 周丽红[3] 张向娥 王晓静[3] 牛敬莲[1] 徐异彩 WU Yanhui;GUO Lijie;ZHOU Lihong(Department of Radiology,Shijiazhuang Fifth Hospital,Hebei,Shijiazhuang 050021,China;不详)

机构地区：[1]河北省石家庄市第五医院放射科,050021 [2]河北省石家庄市第五医院临床药学室,050021 [3]河北省石家庄市第五医院感染科,050021 [4]河北省石家庄市人民医院超声科,050011

出　　处：《河北医药》2021年第8期1208-1211,共4页Hebei Medical Journal

摘　　要：目的综合对比分析不同时期布鲁菌性脊柱炎的影像特征,研究其与病程长短之间的关系,为布鲁菌性脊柱炎临床分期提供依据,指导临床治疗方案的选择和后期随访。方法选取2016年5月至2020年5月收治120例布鲁菌性脊柱炎患者作为入组研究对象,分为急性期组70例,慢性期组50例,分别将2组患者的性别、年龄、椎体、椎间盘、椎旁软组织受累情况的MRI特征等各项指标进行对比分析,重点研究影像学特征与临床分期的关系。结果急性期与慢性期2组患者性别比及年龄差异无统计学意义(P>0.05)。70例急性期布鲁菌性脊柱炎:单节段椎体受累者16例,多位于腰椎,3个椎体受累12例,相邻3个以上椎体14例,跨节段感染6例。病变以单节段椎体破坏为主,L4发病率最高,骨质破坏多局限于椎体边缘,椎体形态正常或仅有轻度楔形变,其中47例患者伴有椎旁脓肿形成,8例伴有椎管内脓肿形成;50例慢性期布鲁菌性脊柱炎:单节段椎体受累者14例,相邻3个椎体受累11例,相邻3个以上椎体33例,跨节段感染6例,慢性期病变分布以多节段、跨节段分布为主;本研究仅有2例椎体呈现压缩、成角畸形,大部分椎体边缘骨质增生较明显呈“花边椎”;7例明显椎旁脓肿,未见椎管内脓肿形成。因此2组患者椎旁脓肿及椎管内脓肿显示率相比差异有统计学意义。结论布鲁菌性脊柱炎急性期与慢性期MRI表现有不同征象,MRI有助于两者进行鉴别诊断。Objective To comprehensively compare and analyze the imaging characteristics of brucella spondylitis at different stages,and to investigate the correlation between the imaging characteristics and the duration of disease,so as to provide the basis for the selection of clinical treatment plan and follow up.Methods A total of 120 patients with brucella spondylitis who were treated in our hospital from May 2016 to May 2020 were enrolled in the study.According to the《Brucella Spondylitis Diagnose and Treatment Guide》enacted in our contry in 2012,these patients were divided into acute phase group(n=70)and chronic stage group(n=50).The patient’s sex and age,MRI features of vertebral body,intervertebral disc and paravertebral soft tissue involvement were compared and analyzed,focusing on the correlation between imaging features and clinical staging.Results There were no significant differences in gender and age between the two groups(P>0.05).In acute stage group,there were 16 cases were involved in single vertebrae,most of which were located in the lumbar spine,12 cases were involved in 3 vertebrae,and 14 cases were involved in 3 or more adjacent vertebrae,and 6 cases were infected across levels.The lesions were mainly single-level vertebral destruction,with the highest incidence in L4.The bone destruction was mostly limited to the vertebral edge,of whom,47 patients were associated with paraspinal abscess formation and 8 patients with intraspinal abscess formation.In chronic stage group,14 cases were involved in single segment vertebral body,11 cases were involved in 3 adjacent vertebral bodies,33 cases were involved in more than 3 adjacent vertebral bodies,and 6 cases were infected across segments.The distribution of chronic stage lesions was mainly multi-segment and cross-segment.In this study,only 2 cases of vertebral bodies presented compression and angulation deformity,and most of the vertebral margins showed obvious hyperplasia of bone as“lacy vertebra”.There were 7 cases of obvious paraspinal abscess wit

关 键 词：布鲁菌病 脊柱炎 临床分期 磁共振成像 

分 类 号：R981.51[医药卫生—药品]