MR对布氏杆菌性脊柱炎诊断价值的探讨

目的:探讨布氏杆菌性脊柱炎在MR影像上的表现特点,提高诊断水平。方法:回顾性分析2009年10月至2010年12月15例布氏杆菌性脊柱炎患者,其中男11例,女4例;年龄31～64岁,平均49岁。均出现不同程度的乏力、发热、出汗、腰痛,均行MR脊柱检查,采用联合抗生素治疗。结果:布氏杆菌性脊柱炎多位于腰椎,椎体边缘明显骨质增生,病灶多位于椎体边缘及椎体前中部,T1序列呈低信号,T2序列呈混杂低信号,T2压脂序列呈高信号;椎间隙多无明显变化;5例出现椎旁脓肿。13例在腰椎,1例为胸腰椎,1例为腰骶椎。14例2个椎体受累,1例3个椎体受累。结论:MR能为布氏杆菌性脊柱炎的诊断及鉴别诊断提供影像学依据,具有较高的临床价值。

Value of magnetic resonance imaging in diagnosis of Brucellar spondylitis

Objective:To study characteristic presentations of Brucellar spondylitis on MRI in order to improve the diagnostic level. Methods:From October 2009 to December 2010,15 patients with Brucellar spondylitis were evaluated by MRI. They included 11 males and 4 females ranging in age from 31 to 64 (mean 49) years. The major clinical manifestations were different degrees of fatigue,fever and low back pain. All patients underwent MRI and treated with antibiotic drugs. Results:Brucellar spondylitis was mostly localized at the lumbar spine with obvious bony hyperostosis in the vertebral periphery. Most foci were in the edge,anterior and middle parts of the vertebral body,with low signals on T1WI and mixed low signals on T2WI,and high signals on T2 fat suppression,mostly without significant changes in intervertebral space. Paraspinal abscess was observed in 5 cases. Thirteen cases involved the lumbar vertebrae,1 case involved the thoracic and lumbar vertebrae,and 1 case involved the lumbar and sacral vertebrae. Two vertebrae were affected in 14 cases,and 3 vertebrae were affected in 1 case. Conclusion:MRI can provide imaging clues for diagnosis and differential diagnosis of Brucellar spondylitis,and has a high clinical value.