布氏杆菌性脊椎炎的MRI表现

目的探讨MRI对布氏杆菌性脊椎炎的诊断价值。资料与方法 16例经临床或手术病理证实的布氏杆菌性脊椎炎行T1WI、T2WI、STIR及增强检查,分析其形态及信号特点。结果病变累及腰椎最多。椎体形态多无明显变化,椎体边缘可见小的骨质破坏及骨质增生。病变椎体T1WI呈低信号,T2WI呈低等或等高信号或低等高混杂信号。STIR呈高信号。增强扫描病变椎体明显强化,与周围正常增强的椎体信号类似或更高。椎间盘7例变窄,信号变化不显著,呈等T1、等T2信号(与邻近椎间盘比较),只有2例T2WI呈高信号。16例均有椎管外软组织受累,呈不均匀长T1、长T2信号,边界模糊,STIR呈混杂高信号,内可见多发大小不等的脓腔,增强扫描显示脓腔壁厚薄不均不规则强化。10例有不同程度椎管内硬膜外脓肿,呈长T1、长T2信号,STIR呈高信号。增强扫描显示脓壁厚薄不均明显强化。脓肿范围较小,一般不超过病变椎体节段。结论布氏杆菌性脊椎炎MRI表现有一定的特征性,MRI对布氏杆菌性脊椎炎诊断及鉴别诊断有重要价值。

MRI Findings of Brucellosis Spondylitis

Objective To explore the value of MRI in diagnosis of brucellosis spondylitis.Materials and Methods 16 cases with clinically or histologically proved brucellosis spondylitis received T1WI,T2WI,STIR and enhanced MRI examination.Morphological and MRI features were analyzed.Results The lesions were mainly located in the lumbar vertebrae.Morphology of vertebral body was almost normal.Bone destruction and osteophyte were detected in the rim of vertebral body.The affected vertebral body showed hypointense on T1WI,hypointense,isointense,hyperintense or heterogeneous intense on T2WI and hyperintense on STIR.After injection of contrast media,signal of affected vertebral body was similar to or higher than that of adjacent vertebral body.16 cases involved paravertebral soft issues with hypointense on T1WI,hyperintense on T2WI and heterogeneous hyperintense on STIR.There were multiple abscess with irregular enhancement in the abscess wall.Epidural abscess was presented as hypointense on T1WI and hyperintense on T2WI,STIR with irregular enhancement in the abscess wall in 10 cases.Range of abscess usually did not surpass the segment of affected vertebral body.Conclusion Brucellosis spondylitism has some MRI characteristics.MRI has significant value in the diagnosis and differential diagnosis of brucellosis spondylitis.