非牧区布鲁菌性脊柱炎的影像特征分析  

Imaging features of Brucella spondylitis in non-pasture areas

作　　者：崔倩 胡家玮 贺丰泰 赵一平[1] Cui Qian;Hu Jiawei;He Fengtai;Zhao Yiping(Department of Radiology,Second Affiliated Hospital,Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院放射科,116027

出　　处：《中华地方病学杂志》2021年第7期588-592,共5页Chinese Journal of Endemiology

摘　　要：目的了解非牧区布鲁菌性脊柱炎(BS)患者的X线、电子计算机断层扫描(CT)及磁共振成像(MRI)影像学特征。方法收集2013年12月至2020年11月大连医科大学附属第二医院确诊收治的21例BS患者病历资料,其中男性14例、女性7例;年龄为(52.4±15.8)岁,范围为21~77岁;均来自于非牧区。诊断标准参照《布鲁氏菌病诊断》(WS 269-2019)标准。回顾性分析影像学检查结果(包括X线、CT、MRI检查,分别为19、16和21例)。结果21例BS患者中,病变部位主要为腰椎(16例,76.2%)。19例X线检查患者中,9例(47.4%)呈"鸟嘴状"骨质增生;7例(36.8%)表现为椎体骨质破坏。16例CT检查患者中,10例(62.5%)表现为骨质增生硬化,8例(50.0%)表现为椎体骨质破坏,均呈现"花边样"特征性改变;7例(43.8%)出现椎间盘受累改变;椎旁和腰大肌脓肿各1例(6.2%)。21例MRI检查患者中,10例(47.6%)表现为骨质增生;11例(52.4%)表现为骨质破坏;13例(61.9%)出现椎间盘信号改变;椎前脓肿、椎旁脓肿、腰大肌脓肿各1例(4.8%)。16例患者同时进行CT、MRI检查,MRI检查在检出椎间盘病变方面优于CT检查(13比7例,χ2=4.800,P<0.05)。结论非牧区BS患者X线、CT及MRI检查影像学表现多样,病变部位主要累及腰椎,且MRI检查在检出椎间盘病变方面优于CT检查。Objective To understand the X-ray,computed tomography(CT)and magnetic resonance imaging(MRI)imaging features of Brucella spondylitis(BS)in non-pasture areas.Methods The medical records of 21 patients with BS diagnosed and treated in the Second Affiliated Hospital,Dalian Medical University from December 2013 to November 2020 were collected.There were 14 males and 7 females.The age was(52.4±15.8)years old,ranging from 21 to 77 years old.They all came from non-pasture areas.The diagnostic criteria refered to the"Diagnosis for Brucellosis"(WS 269-2019).The results of imaging examinations(including X-ray,CT and MRI,19,16 and 21 cases respectively)were retrospectively analyzed.Results In 21 patients with BS,the main lesion site was lumbar vertebrae(16 cases,76.2%).In 19 cases of X-ray examination,9 cases(47.4%)showed"Bird's Beak"hyperostosis,and 7 cases(36.8%)had vertebral bone destruction.Among the 16 cases of CT examination,10 cases(62.5%)had hyperosteosclerosis and 8 cases(50.0%)had vertebral bone destruction,they had been showed the characteristic change of"Lace Like"sign.There were 7 cases(43.8%)of intervertebral disc lesions,1 case(6.2%)of paravertebral abscess and 1 case(6.2%)of psoas major abscess.In 21 patients with MRI examination,10 cases(47.6%)showed hyperostosis and 11 cases(52.4%)showed bone destruction;13 cases(61.9%)had signal changes of intervertebral disc.There were 1 case(4.8%)of prevertebral abscess,1 case(4.8%)of paravertebral abscess and 1 case(4.8%)of psoas major abscess.Sixteen patients underwent CT and MRI examinations at the same time,MRI was superior to CT in detecting intervertebral disc lesions(13 vs 7 cases,χ2=4.800,P<0.05).Conclusion The X-ray,CT and MRI imaging features of BS patients in non-pasture areas are varied,and the lesion site mainly involves the lumbar vertebrae,and MRI is superior to CT in detecting intervertebral disc lesions.

关 键 词：布鲁杆菌病 体层摄影术 X线 磁共振成像 

分 类 号：R516.7[医药卫生—内科学] R681.51[医药卫生—临床医学]