磁共振成像在布鲁氏杆菌性脊柱炎诊断中的应用价值

目的探讨布鲁氏杆菌性脊柱炎的MRI表现,旨在提高对该病的认识,从而提高布鲁氏杆菌性脊柱炎的诊断及鉴别诊断水平。材料与方法回顾性分析我院2015年1月至2017年4月间65例由临床确诊为布鲁氏杆菌性脊柱炎患者的MRI图像,分析其好发部位、椎体形态、各序列信号特征及周围组织情况。结果布鲁氏杆菌性脊柱炎常见于腰椎,多累及椎体前部及中部。其中41例(63.1%)病变椎体形态变化不明显,T1WI显示为低信号,T2WI显示为等或高信号影,精确频率反转恢复(spectral presaturation attenuated inversion recovery,SPAIR)序列为高信号,增强扫描明显强化。53例(81.5%)椎间隙狭窄。58例(89.2%)椎管外软组织受累,椎旁脓肿58例(89.2%),硬膜外脓肿17例(26.2%),脓肿呈不均匀长T1、长T2信号,SPAIR序列呈边界模糊的混杂高信号,内含大小不等、壁厚薄不均且壁明显强化的脓腔。28例(43.1%)患者出现伴随征象,包括椎小关节炎、前纵韧带和棘间韧带钙化。结论布鲁氏杆菌性脊柱炎的MRI表现具有特征性,MRI对诊断及鉴别诊断该病具有重要价值,其中SPAIR序列去除脂肪组织的干扰,可以较敏感地发现病灶,对于病灶及周围情况的显示具有重要意义。

The application of magnetic resonance imaging in the diagnosis of brucellosis spondylitis

Objective: To investigate the MRI findings of brucellosis spondylitis, so as to improve the level of diagnosis and differential diagnosis of brucellosis spondylitis. Materials and methods: The MRI images of 65 patients with brucellosis spondylitis confirmed by clinical were analyzed retrospectively from January 2015 to April 2017. Predilection site of disease, shape and signal characteristics of the vertebral body, characteristics of each sequence signal and the situation of surrounding tissue were analyzed. Results: Brucellosis spondylitis was common on the lumbar spine, and the lesions were located in the anterior and middle part of the vertebral body. The morphological changes of the diseased vertebral body were not obvious in 41 cases, T1WI showed imaging is low signal, T2WI showed high or low signal, the SPAIR sequence showed high signal intensity, and obviously enhanced in the enhanced scan. Intervertebral space narrowed in 53 cases. There were 58 cases of extra vertebral soft tissue were involved, paravertebral abscess in 58 cases, epidural abscess in 18 cases, the signal of abscess was inhomogeneous in long T1 and long T2. SPAIR sequence showed mixed high signals with blurred boundaries, it contains some abscess cavity, which is multiple sizes, uneven thickness wall and obvious enhanced. 28 patients had accompanying signs, including small vertebral joint inflammation, anterior longitudinal ligament and interspinous ligament calcification. Conclusions:MRI manifestations of brucellosis spondylitis are characteristic, MRI has important value in diagnosis and differential diagnosis of brucellosis spondylitis, the SPAIR sequence can remove the interference of fat tissue, can sensitively detect lesions and is of great significance to show the lesion and the surrounding circumstances.