马尔尼菲蓝状菌骨感染病变的影像学分析  

Imaging analysis of Talaromyces marneffei bone infection

作　　者：史晓天 顾玉婷 李凯[1] 李春燕[1] SHI Xiaotian;GU Yuting;LI Kai;LI Chunyan(Department of Radiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2021年第6期985-988,共4页Journal of Practical Radiology

摘　　要：目的分析马尔尼菲蓝状菌(TM)骨感染的影像及临床特征.方法在46例TM感染病例中收集骨感染患者的临床和影像资料,分析TM骨感染的影像学特征.结果35例患者影像发现骨感染病变.数字X线摄影术(DR)发现3例长骨或椎体骨折,1例骨关节病变(4/5);CT发现35例斑点样、斑片状或不规则低密度溶骨性病灶(35/35),其中典型溶骨性骨质破坏15例,骨皮质破坏27例,骨折14例;MRI检查发现8例T_(1)WI低信号、T_(2)WI及抑脂序列高信号病灶,周围软组织增厚、信号增高(8/10),其中5例灶周见环状T_(2)WI高亮信号带,2例T_(1)WI对比增强实质部分轻度强化,灶周炎性水肿带明显强化;23例患者发射型计算机断层显像(ECT)发现骨代谢增高,显像剂异常浓聚(23/26).结论TM骨感染影像表现为累及骨皮质的溶骨性骨质破坏、椎体病灶向中心生长且不累及椎间盘以及骨感染灶与邻近组织病变关系密切等特点.常规放射影像手段(DR、CT及MRI)对检出TM骨感染病变有重要作用.Objective To analyze the imaging and clinical features of Talaromyces marneffei(TM)bone infection.Methods Clinical and imaging data were collected from 46 cases with TM infection,and the imaging features of TM bone infection were analyzed.Results Bone infection lesions were observed in 35 patients on imaging.Digital radiography(DR)found 3 cases of long bone or vertebral body fracture and 1 case of joint diseases(4/5);Thirty-five cases with spotted,patchy and irregular low-density dissolution bone lesions were found on CT(35/35),including 15 cases of typical osteolytic bone destruction,27 cases of bone cortical destruction and 14 cases of fracture;MRI revealed 8 cases of hypointense signals on TiWIfT_(2)WI and lipid suppression sequence,the surrounding soft-tissues were thickened and the signal was increased(8/10),the ring-like high signal intensity band distributed around the lesions was noted in 5 cases on T_(2)WI,slightly enhancement of lesion parenchyma and significantly enhancement of peripheral inflammatory edema were found in 2 cases on contrast-enhanced TiWI;Emission computed tomography(ECT)imaging revealed increased bone metabolism and abnormal high uptake of imaging agent in 23 cases(23/26).Conclusion The imaging features of TM bone infection include osteolytic bone destruction involving cortical bone,vertebral lesions growing toward the center of the vertebral body without involving intervertebral disc and bone infection lesions are closely related to adjacent tissues lesions.Conventional radiographic methods(DR,CT and MRI)play an important role in detecting TM bone infection.

关 键 词：马尔尼菲蓝状菌 骨质破坏 溶骨性病变 磁共振成像 计算机体层成像 

分 类 号：S945.13[农业科学—水产养殖] R681[农业科学—水产科学]