摘要
目的分析总结布氏杆菌性脊柱炎(BS)的磁共振成像(MRI)影像特点,进而评估MRI对布氏杆菌性脊柱炎诊断的临床价值。方法收集2015年1月至2017年12月冀中能源邢矿总医院和邢台市第二医院临床确诊为布氏杆菌性脊柱炎患者47例,男32例、女15例,年龄24~77(57±11)岁,病程1个月~2年。脊柱MRI常规序列扫描。由两名高年资影像诊断医师对图像进行独立评估。评估内容包括:椎体受累部位、椎体及椎间盘的信号改变、椎旁软组织改变的信号特征、病变椎体周围脓肿信号特点、硬膜囊、脊髓和神经根是否受压及相应部位的信号改变等。结果(1)脊柱受累部位:47例BS患者,共发现112个椎体受累,其中颈椎11个(9.8%),胸椎5个(4.5%),腰椎91个(81.2%),骶椎5个(4.5%),受累以腰椎为主。(2)MRI影像特点:112个椎体受累中,105个(93.8%)椎体形态未见明显改变,仅7个(6.2%)椎体轻度压缩塌陷。弥漫性椎体破坏71个(63.4%),局限性椎体破坏41个(36.6%)。47例中,40例为相邻椎体连续性破坏,跳跃性破坏6例,单椎体受累1例;椎间盘受累37例;椎间隙变窄29例;椎旁软组织肿胀11例,椎旁脓肿形成28例。结论MRI对布氏杆菌性脊柱炎诊断具有一定特征性,在鉴别脊柱相关病变中有较高的临床价值。
Objective To analyze the MRI characteristics of Brucellosis spondylitis (BS) and evaluate the clinical value of MRI in the diagnosis of BS. Methods A total of 47 patients clinically diagnosed as BS from General Hospital of Jizhong Energy Xingtai Mining Industry Bloc and Xingtai Second Hospital from January 2015 to December 2017 were collected, including 32 males and 15 females, aged 24-77 years, with an average age of (57±11) years, and the course of disease was 1 month-2 years. Routine spinal MRI sequence were acquired for patients. Images were assessed by two senior imaging diagnostic physician independently. The evaluation included signal changes in the affected area of the vertebral body, vertebral body and intervertebral disc, the signal of paravertebral soft tissue, the signal of abscess around the vertebral body, whether the dural sac, spinal cord and nerve root were compressed or not, and its signal changes. Results (1) Spinal involvement, in 47 patients with BS, 112 vertebral bodies were involved, including 11 cervical vertebrae (9.8%), 5 thoracic vertebrae (4.5%), 91 lumbar vertebrae (81.2%), and 5 sacral vertebrae (4.5%), the lumbar vertebrae was dominant.(2) MRI features, 112 vertebral bodies were involved, including 105 (93.8%) vertebral bodies morphology showed no significant changes, only 7 (6.2%) vertebral bodies showed mild collapse changes;71 vertebral bodies showed diffuse destruction (63.4%), and 41 vertebral bodies showed localized destruction (36.6%). Among the 47 cases, 40 cases were continuous destruction of adjacent vertebral bodies, 6 cases showed non-adjacent damage;37 cases of intervertebral disc involvement;29 cases of narrowing of intervertebral space;11 cases of paravertebral soft tissue swelling and 28 cases showed paravertebral abscess. Conclusion MRI has certain characteristics in the diagnosis of Brucella spondylitis and has a high clinical value in the differential diagnosis of spinal disease.
作者
李会侠
王祺
张建中
李晓辉
冯琳
雷新玮
Li Huixia;Wang Qi;Zhang Jianzhong;Li Xiaohui;Feng Lin;Lei Xinwei(Department of Medical Imaging, General Hospital of Jizhong Energy Xingtai Mining Industry Bloc, Xingtai 054000, China;Department of Medical Imaging, Xingtai Second Hospital, Xingtai 054000, China;Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第37期2935-2938,共4页
National Medical Journal of China
关键词
布鲁杆菌病
脊柱炎
磁共振成像
Brucellosis
Spondylitis
Magnetic resonance imaging
